Full SMAS: Endoscopic-Assisted Full Facial Rejuvenation

Abstract Background Every region of the face may bear the signs of aging. Treating isolated areas without adequate anatomical knowledge can lead to incomplete or artificial-looking results and decrease patient satisfaction. Here, we describe a technique for complete rejuvenation, coined the “Full SMAS” technique, by addressing the anatomical continuity of the SMAS-Platysma to the deep-plane suspension of the face. Objectives This study aims to evaluate the contribution of endoscopic techniques combined with traditional facelift and neck lift procedures. The evaluation is conducted on procedures treating from the frontal and temporal regions of the superior part of the face to its mid and lower parts, including the cervical region. Methods The treatment of the three sub-SMAS layers of the face was performed using endoscopy for repositioning the frontal region and midface. This procedure involves frontal and zygomatic-masseter ligament release, open treatment of the lower subplatysmal section, and the complete release of the retaining ligaments of the face and approach to the jowl. Results One hundred sixty-one patients underwent the Full SMAS technique, leading to long-lasting results, low complication rates, and high patient satisfaction. Conclusions The Full SMAS is a systematic technique that provides complete facial rejuvenation by combining an endoscopic approach for the temporal and midface regions with traditional open approaches for the lower face and neck. Treating the temporal and midface regions using minimally invasive techniques (endoscopy) reduces the possibility of permanent nerve injuries, provides smaller scars, and creates more natural, long-lasting results.