Aesthetic Plastic Surgery

, Volume 35, Issue 4, pp 511–515 | Cite as

SPA Face Lift: SMAS Plication-Anchoring

  • A. Aldo MotturaEmail author
Original Article


A variation of the superficial musculoaponeurotic system (SMAS) plication called SPA face lift is here described. An axial line and then two medial and lateral parallel lines are penciled on the skin from the lateral canthus to the earlobe to show the future plication area. The undermining zone is delimited 1 cm beyond the medial line. In face- and neck-lifting, such marks extend vertically to the neck. Once the skin is undermined up to the delimiting marks, the three lines are penciled again on the fat layer, and a running lock suture is used for plication, with big superficial bites between the two distal lines. In fatty faces, a strip of fat is removed along the axial line to avoid bulging that can be seen through the skin. Because the undermining is limited, minor swelling occurs, and the postoperative recovery is shorter and faster. The same three lines can be marked in the contralateral side or can differ in cases of asymmetry. This report describes 244 face-lifts without any facial nerve problems. The author managed five hematoma cases in which surgery to the neck was performed. Three patients had to be touched up for insufficient skin tension. The SPA technique is consistent and easy to learn.


Face-lifting Neck-lifting SMAS SPA face-lift technique Submucosal aponeurotic system 


Conflicts of interest



  1. 1.
    Mottura AA (2002) Face-lift postoperative recovery. Aesthetic Plast Surg 26:172–180PubMedCrossRefGoogle Scholar
  2. 2.
    Webster G (1972) The ischemic face-lift. Plast Reconstr Surg 50:560PubMedCrossRefGoogle Scholar
  3. 3.
    Webster RC, Smith KF (1983) Face lift: part I. Extent of undermining of skin flaps. Head Neck Surg 5:525Google Scholar
  4. 4.
    Webster RC, Smith RC, Papsidero MJ et al (1982) Comparison of SMAS plication with SMAS imbrication in face-lifting. Laryngoscope 92:901PubMedCrossRefGoogle Scholar
  5. 5.
    Baker D (1997) Lateral SMASectomy. Plast Reconstr Surg 100:509PubMedCrossRefGoogle Scholar
  6. 6.
    Baker DC, Stefani WA, Chiu ES (2005) Reducing the incidence of hematoma requiring surgical evacuation following male rhytidectomy: a 30-year review of 985 cases. Plast Recosntr Surg 116:1973CrossRefGoogle Scholar
  7. 7.
    Baker DC (1994) Deep disecction rhytidectomy: a plea for caution. Plast Reconstr Surg 93:1498PubMedCrossRefGoogle Scholar
  8. 8.
    Waterhouse N, Vesely M, Bulstrode N (2007) Modified lateral SMASectomy. Plast Reconstr Surg 119:1021PubMedCrossRefGoogle Scholar
  9. 9.
    Tonnard P et al (2002) Minimal access cranial suspension lift: a modified S-lift. Plast Reconstr Surg 109:2074–2086PubMedCrossRefGoogle Scholar
  10. 10.
    Fogli A, Descuches C (2008) Less invasive face-lifting: platysma-anchoring techniques. Clin Plast Surg 36:519–529CrossRefGoogle Scholar
  11. 11.
    Roberts TL, Pozner JN, Ritter E (2000) The RAVP face-lift: a highly vascular flap permitting safe, simultaneous, comprehensive facial rejuvenation on one operative setting. Aesthetic Plast Surg 24:313–322; (1983) Head Neck Surg 5:525Google Scholar
  12. 12.
    Whetzel TP, Mathes SJ (1997) The arterial supply of the face-lift flap. Plast Reconstr Surg 100:480–486PubMedCrossRefGoogle Scholar
  13. 13.
    Mottura AA (1999) Cervical rhytidectomy. Aesthetic Plast Surg 23:179–188PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2011

Authors and Affiliations

  1. 1.Centro de Cirugía EstéticaCórdobaArgentina

Personalised recommendations