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A facelift, also known as a meloplasty or rhytidectomy, removes descending or excess skin from the mid and lower face and tightens the underlying tissues. It treats the cheeks, jowls, and jawline and is commonly combined with other cosmetic procedures.

Over the years, surgical innovation has led to the development of new techniques. One of these is the gold-standard high SMAS facelift technique. Unlike earlier methods, this procedure addresses not only the lower face but also the skin and soft tissues above the cheekbones and mid-face.

What is High SMAS Surgery?

High SMAS surgery is a facelift technique that focuses not only on repositioning the soft tissues of the lower face but also the mid-face. The SMAS (Superficial Muscular Aponeurotic System) refers to the fibro-muscular network that extends throughout the face and neck, beneath the overlying fat and skin. Modern facelift techniques involve lifting, releasing, and repositioning the SMAS layer, which supports the structures of the face and neck.

A high SMAS facelift tightens skin, repositions tissue, and removes excess skin by mobilising the SMAS near the cheekbones. The surgery can address the following:

  • Descending skin in the mid-face
  • Nasolabial folds
  • Jowls
  • Descending skin and fat along the jawline and chin

What to Expect During Your High SMAS Facelift Consultation

Before the procedure, Dr Richardson will discuss what you hope to achieve from a high SMAS facelift. He will ask you about your current health and medical history, the extent of your skin laxity, and which areas of your face you are most concerned about. This will allow us to develop a tailored surgical treatment plan that addresses those areas.

Dr Richardson may recommend additional procedures to help you attain your goals, including skin resurfacing, facial fat grafting, a brow lift, blepharoplasty eyelid surgery, or a neck lift procedure.

After your consultation, you should clearly know what to expect from a high SMAS facelift, including the aftercare process.

The Procedure

On the day of surgery, a high SMAS facelift will be performed under general anaesthesia in an accredited hospital with an overnight stay. Dr Richardson will carefully make incisions at the sides of the face, beginning at the temples and moving downwards behind the ears. The skin is then lifted, and the SMAS mobilised and carefully secured, with the excess skin removed. During this process, Dr Richardson redistributes the fat. Care is taken to hide incisions within your natural skin creases and behind the hairline to reduce scar visibility.

The procedure combines cheek lift, neck lift, and eyelid lift techniques. It can take several hours and depends on the extent of your skin laxity and the specific techniques employed during surgery.

Other surgical procedures, including liposuction and facial fat grafting, or non-surgical treatments with LED (Healite), ultrasound or radiofrequency (RF) therapy, may be recommended.

Cost of High SMAS Facelift Surgery

The fees associated with a high SMAS facelift can depend on several factors. When calculating the overall fees, we must consider the anaesthetist fees, hospital fees, and other related costs such as medications. The extent of the surgery can also impact your fees. We will discuss these during your consultation to ensure you are fully informed and prepared. Due to the personalised nature of aesthetic cosmetic surgery, we can answer any questions you may have during your private discussion.

Occasionally, you may be eligible for an MBS (Medicare Benefits Schedule) Item number for the procedure. If so, Medicare and private health insurance may cover a portion of your total fee. Our team will advise and guide you.

Your Personal Consultation

Request a Consultation

Your personal consultation is the first step to finding the right procedure for you. Dr Richardson is a highly skilled Specialist Plastic Surgeon, dedicated to providing quality results and a positive patient experience.

Book your appointment to
  • Discuss your physical concerns and goals
  • Receive an outline of your surgical options
  • Get quality advice from a trained Specialist Plastic Surgeon
  • Receive a customised treatment plan
  • Meet Dr Richardson’s Patient Coordinator and team, who will support you throughout your journey


Immediately after surgery, Dr Richardson will dress and bandage your incisions and may apply tubes to drain excess fluid from the neck. It is normal to feel some discomfort, and you will be given prescription medications to help you settle and recover after the procedure. Most patients return home after one night in the hospital, and it is important that you organise a family member or trusted friend to drive you home. Your support person will also need to stay with you for at least the first 48 hours after your arrival at home to help you with day-to-day tasks until you can safely return to your normal tasks.

Aftercare is an important aspect of surgery. Prior to your discharge, you will be given specific instructions to help you take appropriate care of your incisions. It is also a good idea to:

  • Get plenty of rest, with your head elevated.
  • Do not flex your neck forward.
  • Take prescribed pain medication.
  • Avoid spending time in the sun.
  • Wear your compression garment.
  • Maintain a healthy diet and stay hydrated.
  • Avoid smoking and alcoholic drinks.
  • Contact us if any issues arise or if you have any concerns.
  • Sleep on your back so as not to put pressure on your incisions.

As a guide, most patients can expect the following recovery after high SMAS facelift surgery:

  • Initial discomfort: 1-2 weeks
  • Return to activity: 1 week
  • Return to work: 2-3 weeks
  • Post-op compression garments: 4 weeks
  • Return to travel: 6 weeks
  • Return to social functions: 6-8 weeks
  • Return to exercise: gentle walk after one week, gym from 6-8 weeks
  • Return to driving: 2-3 weeks. Patients must be fully alert, no longer taking any sedating medications, and be able to move freely without restriction.

Dr Richardson and his team will guide you further according to your specific circumstances.

Following a facelift, it is important to maintain the results you have achieved. We recommend avoiding smoking, living a healthy lifestyle, and regularly applying sun protection with a high SPF and skincare.

Risks and Complications

Following high SMAS facelift surgery, you can experience some mild swelling, bruising, and skin tightness. These are common following such procedures and will subside over the course of your healing process.

Complications after high SMAS Facelift procedures include:

  • Persistent pain and swelling
  • Bleeding
  • Reactions to anaesthesia
  • Infection and fluid collection
  • Poor or slow healing
  • Minor facial asymmetry
  • Skin discolouration
  • Nerve weakness or numbness
  • Further adjustment procedures

If you have any concerns or queries, please contact us promptly.

High SMAS Facelift FAQ

Am I a suitable candidate for a high SMAS Facelift?

Will I have scars afterwards?

When can I resume my normal activities?

When will I see the results?

What do I need to know when preparing for surgery?