Before and After Lifting in Your 40s: A SMAS Volume Lift Case for a Smaller Face Without Bone Surgery

Lifting in your 40s goes beyond simply pulling the skin; the key is to enhance the three-dimensional contour of the face. This is because a multi-dimensional approach is required to lift tissues that sag with age and fill in areas lacking volume. Today, through a SMAS Volume Lift case of a woman in her late 40s performed at 345 Plastic Surgery, we will look at how to achieve the transformation of a smaller-looking face without bone surgery.

A Lifting Plan That Reduces the Burden of Bone Surgery

A 47-year-old female patient residing overseas visited our clinic after being highly satisfied with her son's facial contouring surgery results. She also wanted to improve the impression of having a large face, but she felt significant burden and fear regarding bone-shaving surgery.

Reflecting the patient's concerns, 345 Plastic Surgery planned a SMAS Volume Lift to improve her impression without touching the bones. This is a procedure that combines a minimal-incision lift with facial fat repositioning to simultaneously refine the size and line of the face.

Analyzing the Causes of a Large-Looking Face and Designing Three-Dimensionality

Upon analyzing the patient's initial condition, the cause was not simply the size of the bones, but the distribution of fat and muscle.

• Concentrated Lower Volume: Fat had accumulated along the jawline and under the chin, making the lower face look heavy.
• Muscle Development: The masseter (jaw) muscles were developed, creating a wide-looking impression from the sides.
• Lack of Three-Dimensionality: The front cheekbones and the area above the eyebrows were flat, making the face appear larger than it actually was.

The solution lay in 'three-dimensionality.' To reduce the wide, spread-out appearance, fat from the lower face was liposuctioned and grafted into necessary areas such as the front chin and front cheekbones to enhance the volume in the center of the face. By doing this, the overall volume is maintained, but the gaze is drawn to the center, making the face look smaller and more three-dimensional.

The SMAS Volume Lift Surgical Process

One week before the surgery, we performed preliminary work to reduce muscle volume using jaw Botox. On the day of the surgery, the following process was carried out with precision:

1. Fat Liposuction and Purification: Approximately 12cc of fat was extracted from the jawline and under the chin.
2. Fat Grafting: The liposuctioned fat was used to supplement the length of the front chin and grafted into the front cheekbones and sunken areas above the eyebrows to create three-dimensionality.
3. Upper Eyelid Correction: Fat was grafted into the sunken upper eyelids, caused by a habit of raising the eyebrows, to improve an aged impression.
4. SMAS Lifting: The SMAS layer, the muscle layer beneath the skin, was pulled to tighten and refine sagging skin.

Post-Operative Progress and Aftercare

Due to the patient residing overseas, we checked her progress by periodically receiving photos via messenger. We assisted her recovery by monitoring the process of her facial lines stabilizing in real-time after the surgery.

When we checked in person during her recent visit back to Korea, a smoother jawline and a more three-dimensional facial contour had formed than expected. The patient expressed very high satisfaction with achieving her desired transformation without bone surgery.

Conclusion: Finding the Optimal Lift for You

Bone surgery is not the answer to all concerns about facial size. By comprehensively analyzing skin elasticity, fat distribution, and the degree of muscle development, a sufficiently refined impression can be created through lifting and volume control alone. It is important to consult with highly experienced medical professionals to establish the most suitable plan for yourself.