Profound understanding of the surgical anatomy of the face and neck is the key to successful face lift surgery. The "Segmental SMAS Model" presented herein is the result of a decade-long effort in teaching fellows a logical and coherent anatomic model of face lift anatomy. The superficial musculo-aponeurotic system (SMAS) consists of segments with distinct surgical characteristics. These are determined by the presence of a deep gliding plane and/or adhesion through fibrous insertions. In this article, we define SMAS segments that are profoundly heterogeneous in their behavior and have surgical implications on the maneuvers required for a deep plane face lift. The present model introduces several novel interpretations of the surgical anatomy of the face and neck lift procedure and hopes to convey a better understanding of face lift anatomy to training surgeons.
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