SMAS Lift: Natural Results without artificial effect

Deep facial rejuvenation with natural and lasting results.

Starting from: €12,000

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Duration of surgery:

2 to 4 hours

Social recovery:

14-21 days

Duration of result:

8 – 12 years

Anesthesia:

General anesthesia

Table of contents

01 Price
02 Results
03 Postoperative
04 Medical Group

What is a SMAS?

A SMAS lift is a facial plastic surgery procedure designed to reposition the deep structure of the face, not just the skin, by acting on the Superficial Musculo-Aponeurotic System (SMAS) layer. Through hidden incisions around the ear contour and hairline, the surgeon elevates this fibromuscular layer in its upper portion, secures it with non-absorbable sutures to stable structures, and redrapes the skin without tension.

The result is a rested, defined, and harmonious face, without the "pulled-back" effect associated with skin lifts of previous generations. The duration of the result ranges between 8 and 12 years, making the SMAS lift the facial rejuvenation procedure with the best investment-to-longevity ratio in the current surgical catalog.

What approaches and techniques exist

Classic SMAS lift (plication):

The surgeon makes a periauricular incision and folds the SMAS layer onto itself with sutures, without extensive dissection. It is the most conservative approach, ideal for mild-moderate laxity in patients with good skin quality.

High SMAS lift:

The SMAS layer is elevated above the zygomatic arch and repositioned in a block upwards and backwards following a vertical vector. It restores volume to the midface and redefines the facial oval. It is the most demanded technique in patients between 45 and 60 years old with moderate laxity of the mid and lower third.

SMAS-ectomy (Baker):

Instead of folding the SMAS, a band of tissue is resected and the upper edge is sutured to the lower edge. Indicated in patients with thickened SMAS and severe sagging of the lower third.

Extended SMAS / Deep Plane Lift (alternative):

When the sagging of the midface is pronounced and the facial ligaments are retracted, the sub-SMAS plane and the zygomatic and mandibular ligaments are released. It is not a standard SMAS, but a related technique that we offer as an alternative when the anatomy requires it.

Extended SMAS / Lifting Deep Plane (alternativa):

Medical evidence and support

SMAS surgery is supported by more than five decades of scientific literature (initially described by Mitz and Peyronie in 1976 and refined by Owsley, Hamra, and Marten). At the Instituto de Benito, we apply internationally consolidated technical principles, and our practice is supported by membership in scientific societies such as:

SECPRE (Spanish Society of Plastic, Reconstructive and Aesthetic Surgery)
ISAPS (International Society of Aesthetic Plastic Surgery)
SCCPRE (Catalan Society of Plastic, Reconstructive and Aesthetic Surgery)

This membership ensures continuous training, peer review, and the application of the safest state-of-the-art techniques.

What does a SMAS lift involve?

The process begins with a personalized assessment with the surgeon who will operate. This is not a commercial: it is the doctor who will study your anatomy, explain the technique indicated for your case, mark the incisions on the day of surgery, and accompany you throughout the postoperative period. This continuity—the same surgeon who evaluates is the one who operates and reviews—is one of the pillars of the Instituto de Benito model.

Medical assessment of the SMAS lift:

It is carried out with the surgeon who will operate on you. It includes static and dynamic facial analysis, assessment of skin quality, indicative digital simulation, and selection of the specific technique (plication, High SMAS, SMAS-ectomy, or Deep Plane). To book the appointment, a fee of €80 must be paid in advance.

Preparation for the procedure

Complete preoperative analysis, electrocardiogram, consultation with the anesthesia team, suspension of antiplatelet agents, and smoking cessation (at least 3 weeks prior). We provide you with a dossier with day-to-day instructions.

The procedure

Surgery lasting 2 to 4 hours under general anesthesia or deep sedation with local anesthesia. 24-hour admission with full monitoring. Incisions designed to be hidden within the hair and around the ear contour.

Supervised recovery

Compressing bandage for the first 24-48 hours, removal of drains at 48 hours, check-up at 7-10 days for suture removal and scheduled check-ups at 3 weeks, 3 months, 6 months, and 12 months with the same surgeon.

Start looking how you want to feel.

Visible result at 80-90% around the third month. Final result at 6-12 months, when the scar matures. What your surroundings will see: a rested, not operated face.

Preparation and recovery of the SMAS lift

Before surgery

The personalized assessment studies the anatomical characteristics of the face, skin quality, position of facial ligaments, and aesthetic goals. In this phase, it is decided:

Specific SMAS technique (plicature, High SMAS, SMAS-ectomy, or Deep Plane).
Dissection plane and traction vector.
Need for associated procedures (blepharoplasty, neck lift, fat transfer).
Preliminary design of incisions.

Before operating, blood tests, ECG, anesthetic evaluation, and signing of the specific informed consent are carried out. Written recommendations are provided: scheduled suspension of antiplatelet agents, cessation of smoking at least 3 weeks before, preoperative fasting, and preparation of the home environment for the postoperative period.

Preparation and recovery of the <em>SMAS lift</em>

After surgery

After surgery, a progressive recovery begins. It is common to experience marked swelling, bruising on cheeks and neck, and a feeling of tightness. It is not a particularly painful surgery; tightness predominates over pain, but it requires rest and discipline with the instructions.

During the first weeks, it is recommended:

Sleep elevated at 30-45° for the first 2 weeks to reduce swelling.
Avoid direct sun exposure for 2 months and apply SPF 50+ sunscreen on scars for a year.
Do not smoke throughout the postoperative period.
Daily facial hydration with gentle products recommended by the team.
Attend scheduled check-ups: 7-10 days, 3 weeks, 3 months, 6 months, and 12 months.
Avoid aggressive facial massages and aesthetic medicine treatments for at least 3 months.

Reintegration into social and work life occurs between the 2nd and 3rd week. Light sports practice resumes in the 4th week. The final result consolidates at 6-12 months.

What is the price of the SMAS lift?

From €12,000. The SMAS lift at Instituto de Benito starts from €12,000 for the isolated procedure in moderate sagging. It is a fixed amount and provided in writing after the assessment: it is not a commercial "from" behind which unexpected extras appear.

What makes the price vary

The final budget may increase from the base price due to these factors, always communicated in writing before surgery:

Indicated technique: plication, High SMAS, SMAS-ectomy, or Deep Plane. The Deep Plane technique requires more surgical time and greater complexity.
Combined procedures: blepharoplasty, neck lift, or fractional laser in the same intervention.
Revision surgery: on a previous lift, requires more time and greater technical skill.
Specific preoperative tests if the clinical case requires it.

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Are you suitable for SMAS lift surgery?

The SMAS lift does not transform your face: it returns it to a more youthful point of your own identity. You are in the indicated profile if you identify with any of these cases:

01
People between 45 and 60 years old with moderate sagging:
The facial oval loses definition, the cheeks descend, the initial double chin appears, and the nasolabial folds deepen. The SMAS lift repositions these structures as a block.
02
Patients with reasonable skin quality:
The surgery repositions the structure, but does not rejuvenate the skin. If there is severe sun damage, it is combined with fractional laser or peels to improve texture.
03
Those who prioritize naturalness over drastic change:
The SMAS lift is designed to be unnoticeable. The result is a rested face, not transformed.
04
Aesthetic medicine results that are no longer sufficient:
When hyaluronic acids, radiofrequency, or thread lifts no longer provide visible improvement because the sagging is structural, the SMAS lift is the next logical step.
05
Patients who have sought a second opinion:
We frequently receive patients who have been evaluated at other clinics and seek to confirm the indication or explore alternative techniques. The evaluation with the surgeon also serves this purpose.
06
Long-lasting result as a priority:
If you are looking for a result that lasts 8-12 years instead of annual touch-ups, the SMAS lift is the procedure with the best balance between investment, recovery, and permanence.

Who is NOT suitable: contraindications of the SMAS lift

SMAS lifting is a safe surgery when performed with rigorous medical criteria, but there are situations where it is contraindicated or should be postponed. At Instituto de Benito, we always evaluate this in the preoperative assessment, above any commercial consideration.

Contraindication	Reason
Active smoking not susceptible to pause	Nicotine reduces skin blood flow and severely compromises healing, increasing the risk of necrosis of skin flaps. We require smoking cessation at least 3 weeks before and 3 weeks after.
Treatment with anticoagulants or antiplatelets that cannot be suspended	Increases the risk of hematomas, intraoperative bleeding, and scarring complications. Requires coordination with the prescribing doctor.
Severe coagulation disorders	High risk of cervicofacial hematoma. Requires prior hematological evaluation.
Decompensated cardiopulmonary diseases	Increase anesthetic risk. Must be stabilized before considering surgery.
Poorly controlled diabetes	Compromises healing and increases the risk of infection. Requires controlled HbA1c.
Active local or systemic infection	Increases the risk of wound infection and scarring complications. Postponed until complete resolution.
Body dysmorphic disorder or unrealistic expectations	When motivation is due to a distortion of body image or anatomically impossible expectations, no technique will resolve the dissatisfaction. Requires prior psychological evaluation.
Previous facial surgery with inadequate healing	Recent facial surgery with unresolved complications must be stabilized before considering a new intervention.
Very compromised skin quality (isolated severe photoaging)	SMAS lifting does not rejuvenate the skin: it repositions the structure. If the main problem is skin quality, skin techniques should be combined or other treatments prioritized.
Active autoimmune diseases	Require individualized rheumatological evaluation. Surgery is assessed on a case-by-case basis.
Age under 30 for aesthetic purposes without anatomical indication	Structural sagging rarely justifies a SMAS before the age of 35-40. In that range, non-surgical treatments are prioritized.

Risks and possible side effects of SMAS lifting

SMAS lifting is major surgery. We work with an accredited operating room, certified anesthesiologist, complete monitoring, and 24-hour admission. This drastically reduces the incidence of complications, but the patient must be aware of them before signing the informed consent.

If after surgery there is intense pain that does not subside with prescribed analgesia, fever above 38 °C, increasing cervical hematoma (causing a feeling of pressure in the throat), sudden asymmetry of the smile or forehead, or discharge from the wound, contact the clinic immediately or go to the nearest emergency service.

Expected and mild reactions (most self-limit within 7-14 days)

Marked facial swelling, peaking at 48-72 hours.
Bruising on cheeks, jaw angle, and neck.
Feeling of tightness and periauricular numbness.
Transient alteration of auricular pavilion sensitivity for 2-6 months.
Hardening of tissues in the dissected area for weeks.

Less frequent effects

Mild transient asymmetries that resolve with scar maturation.
Hypertrophic scarring in predisposed patients (requires specific follow-up).
Need for minor touch-up in consultation (rare).

Uncommon complications (preventable with rigorous practice)

Significant hematoma requiring surgical drainage (1-3% of cases).
Wound infection (very rare with perioperative antibiotic prophylaxis).
Transient injury to branches of the facial nerve: temporary weakness of the smile or forehead, usually reversible in weeks. Permanent injury is extremely rare in expert hands.
Skin necrosis: extremely rare, almost always associated with non-compliance with smoking cessation.
Keloid scarring (in patients with a history).

Our medical group in SMAS lifting

The Instituto de Benito is a reference in facial plastic surgery with over 35 years of experience and one of the most experienced surgical schools in SMAS surgery in Spain. Our team combines surgical artistry, technical precision, and emotional care, ensuring natural and safe results.

Dr. Javier de Benito | IdB

Plastic surgeon and medical director. International reference in facial surgery.

View medical profile

Dr. David Neagu, specialist in facial and maxillofacial

Surgeon specializing in facial and maxillofacial

View medical profile

Dr. Álvaro Sada Malumbres, specialist in facial, oral and maxillofacial

Surgeon specializing in facial, oral and maxillofacial

View medical profile

Dr. Antonio Martínez Murillo, specialist in facial, body, and breast surgery

Surgeon specializing in facial, body, and breast surgery

View medical profile

Meet the whole team

Medical guarantees and certifications of your SMAS lifting

We have a solid track record backed by over 35 years of experience in plastic and aesthetic surgery, with a special dedication to facial surgery. Throughout our career, we have been a reference school in SMAS technique and participate in the continuous training of surgeons through SECPRE and ISAPS.

Where to have a SMAS lift surgery

Instituto de Benito: Plastic surgery, aesthetic medicine and wellness in Barcelona

Instituto de Benito: Plastic surgery and aesthetic medicine in Madrid

Instituto de Benito International Plastic Surgery

Related treatments

See deep plane face lift surgery

Deep plane facelift

The Deep Plane FaceLift is the most advanced facial lifting technique, designed to rejuvenate, firm, and reposition the deep tissues of the face when there is sagging, drooping, and loss of definition caused by aging, gravity, and the passage of time.

View facelift surgery

Facelift

The facelift is a surgical procedure designed to rejuvenate, firm, and reposition facial tissues when they exhibit sagging, drooping, or loss of definition due to aging, gravity, or the passage of time.

See brow lift surgery

Brow lift

The brow lift or eyebrow lift is a procedure aimed at repositioning the eyebrows when they have descended over time or give a tired or sad appearance to the gaze.

Frequently asked questions about the SMAS lift

How much does a SMAS lift cost at Instituto de Benito?

From €12,000 for an isolated SMAS lift. The exact quote is provided in writing after a personalized assessment with the surgeon.

How long do the results last?

Returning to social and work life occurs between the 2nd and 3rd week. Light sports can be resumed in the 4th week. The final result is consolidated at 6-12 months.

Are the scars noticeable?

The incisions are hidden within the hair, around the ear contour, and in the retroauricular fold. At 6-12 months, they are practically imperceptible.

Is the postoperative period painful?

Most patients report tightness and numbness rather than pain. Discomfort is managed with oral analgesia for the first 48 hours.

Can I finance the SMAS lift?

Yes. We work with an associated financial entity that allows financing up to 60 installments. The financial assessment is carried out after the medical consultation.

Is hospitalization required?

Yes, 24 hours with full monitoring. Discharge is given the next day with a follow-up included at 48 hours.

Can I combine the SMAS lift with other surgeries?

Yes, and it is very common. Usual combinations are: blepharoplasty, neck lift, facial fat transfer, and fractional laser.

In which cities do you perform SMAS lifts?

In Barcelona and Madrid.

When will I see the final result?

80-90% of the result is visible by the 3rd month. The final result, when the scar matures, is seen between 6 and 12 months.

At what age is it recommended?

The indication depends on anatomy, not a specific age. The usual range is 45-60 years, but there are 42-year-old patients with marked genetic laxity who benefit, and 65-year-old patients who still do not need it.

And if I want a subtle, non-surgical change?

In incipient laxity, we consider alternatives such as deep radiofrequency Ultherapy or threads. We only propose surgery when the anatomical indication justifies it.

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Average rating: 4.8 / 5

Based on 651 reviews

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Laura Rojals

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hace 1 año

Me he hecho una higiene facial y me ha encantado. Han tenido en cuenta mi tipo de piel y me han adecuado el tratamiento. Lo recomiendo muchísimo!

Nast

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hace 2 años

Esperiencia excepcional. La esteticista fue profesional y amable, explicándome cada paso del proceso. La limpieza en sí fue muy efectiva; mi piel quedó notablemente más suave y radiante al final. Además, el ambiente fue tranquilo y los productos utilizados de alta calidad. Sin duda, recomendaría este tratamiento de...

Maria Vandellós

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hace 2 años

Me estoy haciendo el tratamiento facial Detox de Glow by Anna y es espectacular cómo de agradecida siento la piel! Son muy profesionales todos y es un placer haber conocido este centro. Recomendable 100%!

paula tio

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hace 3 años

El trato del personal ha sido excelente, el lugar tiene mucho encanto y te transmite paz y el facial que me han hecho ha sido el mejor que me he hecho nunca. ¡Muy contenta con el servicio y mi experiencia en Instituto de Benito!

Ana Jorge de Sá Ribeiro Ferreira

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hace 3 años

Me ha encantado la experiencia, muy relajante. Además, el espacio es muy agradable. Me atendió Blanca y me hizo una higiene y hidratación facial, muy buen trato! Lo recomiendo!

Areia Estibalez de Cardona

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hace 3 años

Hace unos meses que voy a Instituto de Benito a hacerme tratamientos faciales. He tenido muchos problemas de acné y hasta que no he probado el láser, no he visto la luz de verdad. Realmente es un tratamiento que no es nada económico pero, vale la pena! De momento solo me he hecho 2 sesiones y los cambios son...

Carla Miracle

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hace 3 años

Avui he anat per primera vegada a la clínica per realitzar-me una higiene facial i el tracte ha estat impecable. Han mirat el meu tipo de pell i segons les característiques m’han recomenat una higiene ajustada a la meva pell. Gràcies per tot, especialment a Alicia.

Judit

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hace 4 años

Me parecen muy profesionales, la verdad, aparte que son muy sinceros en cuanto a darte su opinión a tratamientos que pides. Y eso no todo profesional lo tiene y es de agradecer. Instalaciones espectaculares y personal de momento 10/10. Me asesoraron hace tiempo para tratamientos antimanchas y hoy he ido a hacerme...

Elena Artigas

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Las mejores limpiezas faciales. Acabas con una luminosidad espectacular. Trato muy profesional.

Sofia Zapater Zamora

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Me he realizado una limpieza de cara y perfecto! La piel me ha quedado hidratada y limpia y además sin rojeces, cosa que es difícil porque tengo la piel muy sensible. Además la atención es de 10.

Carmen Bolanos

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hace 4 años

La semana pasada tu la ocasión de disfrutar de un tratamiento wellness Facial en el Instituto de Benito, y puedo decir que la experiencia fue un lujo. El tratamiento fue una maravilla, espero repetir y lo recomiendo al 200%. El trato recibido por su personal fue inmejorable, excelente y las instalaciones también son...

Rachida_ El bouazzaoui

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hace 5 años

Me encanta esta clínica IdB la verdad que son unos encantos de personas te atiende muy bien la chica que atendió es un encanto de l doctor también la verdad que me fue muy bien me cara esta bastante bien aunque me quedan aún sesiones por hacer

Clara Cañabate Berenguer

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hace 5 años

Increíble experiencia. Fabuloso. Solo tengo palabras buenas para este sitio. Me he hecho una limpieza facial fantástica, exhaustiva, con una atención inmejorable. Me han resuelto cualquier duda sobre mi piel. Relación calidad-precio realmente buena. Volveré a por unas sesiones de Jetpeel.

Mireia Rigo

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Una experiencia muy buena por ser la primera vez! Me sentí muy mimada cuando fui hacerme una limpieza facial y me dieron muy buenos consejos sobre que tratamiento hacer para mejorar el estado de mi piel. Los resultados se ven al momento y la sensación es brutal! Muchas gracias!!

Emilia Rostkowska

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hace 5 años

Very positive experience. I did facial cleansing. Finished with face and neck massage. I'm very happy with the result. Highly recommended the place!

Laura Rojals

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hace 1 año

Me he hecho una higiene facial y me ha encantado. Han tenido en cuenta mi tipo de piel y me han adecuado el tratamiento. Lo recomiendo muchísimo!

Nast

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Maria Vandellós

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paula tio

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hace 3 años

Ana Jorge de Sá Ribeiro Ferreira

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hace 3 años

Me ha encantado la experiencia, muy relajante. Además, el espacio es muy agradable. Me atendió Blanca y me hizo una higiene y hidratación facial, muy buen trato! Lo recomiendo!

Areia Estibalez de Cardona

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hace 3 años

Carla Miracle

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hace 3 años

Judit

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hace 4 años

Elena Artigas

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hace 4 años

Las mejores limpiezas faciales. Acabas con una luminosidad espectacular. Trato muy profesional.

Sofia Zapater Zamora

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hace 4 años

Me he realizado una limpieza de cara y perfecto! La piel me ha quedado hidratada y limpia y además sin rojeces, cosa que es difícil porque tengo la piel muy sensible. Además la atención es de 10.

Carmen Bolanos

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hace 4 años

Rachida_ El bouazzaoui

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hace 5 años

Clara Cañabate Berenguer

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hace 5 años

Mireia Rigo

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hace 5 años

Emilia Rostkowska

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hace 5 años

Very positive experience. I did facial cleansing. Finished with face and neck massage. I'm very happy with the result. Highly recommended the place!

Laura Rojals

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hace 1 año

Me he hecho una higiene facial y me ha encantado. Han tenido en cuenta mi tipo de piel y me han adecuado el tratamiento. Lo recomiendo muchísimo!

Nast

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hace 2 años

Maria Vandellós

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hace 2 años

paula tio

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hace 3 años

Ana Jorge de Sá Ribeiro Ferreira

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hace 3 años

Me ha encantado la experiencia, muy relajante. Además, el espacio es muy agradable. Me atendió Blanca y me hizo una higiene y hidratación facial, muy buen trato! Lo recomiendo!

Areia Estibalez de Cardona

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hace 3 años

Carla Miracle

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hace 3 años

Judit

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hace 4 años

Elena Artigas

Google

hace 4 años

Las mejores limpiezas faciales. Acabas con una luminosidad espectacular. Trato muy profesional.

Sofia Zapater Zamora

Google

hace 4 años

Me he realizado una limpieza de cara y perfecto! La piel me ha quedado hidratada y limpia y además sin rojeces, cosa que es difícil porque tengo la piel muy sensible. Además la atención es de 10.

Carmen Bolanos

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hace 4 años

Rachida_ El bouazzaoui

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hace 5 años

Clara Cañabate Berenguer

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hace 5 años

Mireia Rigo

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hace 5 años

Emilia Rostkowska

Google

hace 5 años

Very positive experience. I did facial cleansing. Finished with face and neck massage. I'm very happy with the result. Highly recommended the place!

What is a SMAS?

Classic SMAS lift (plication):

High SMAS lift:

SMAS-ectomy (Baker):

Extended SMAS / Deep Plane Lift (alternative):

Medical evidence and support

What does a SMAS lift involve?

Medical assessment of the SMAS lift:

Preparation for the procedure

The procedure

Supervised recovery

Start looking how you want to feel.

Preparation and recovery of the SMAS lift

Before surgery

After surgery

What is the price of the SMAS lift?

What makes the price vary

Are you suitable for SMAS lift surgery?

People between 45 and 60 years old with moderate sagging:

Patients with reasonable skin quality:

Those who prioritize naturalness over drastic change:

Aesthetic medicine results that are no longer sufficient:

Patients who have sought a second opinion:

Long-lasting result as a priority:

Who is NOT suitable: contraindications of the SMAS lift

Risks and possible side effects of SMAS lifting

Expected and mild reactions (most self-limit within 7-14 days)

Less frequent effects

Uncommon complications (preventable with rigorous practice)

Our medical group in SMAS lifting

Dr. Javier de Benito | IdB

Dr. David Neagu, specialist in facial and maxillofacial

Dr. Álvaro Sada Malumbres, specialist in facial, oral and maxillofacial

Dr. Antonio Martínez Murillo, specialist in facial, body, and breast surgery

Medical guarantees and certifications of your SMAS lifting

Where to have a SMAS lift surgery

Instituto de Benito: Plastic surgery, aesthetic medicine and wellness in Barcelona

Instituto de Benito: Plastic surgery and aesthetic medicine in Madrid

Instituto de Benito International Plastic Surgery

Related treatments

Deep plane facelift

Facelift

Brow lift

Frequently asked questions about the SMAS lift

How much does a SMAS lift cost at Instituto de Benito?

How long do the results last?

Are the scars noticeable?

Is the postoperative period painful?

Can I finance the SMAS lift?

Is hospitalization required?

Can I combine the SMAS lift with other surgeries?

In which cities do you perform SMAS lifts?

When will I see the final result?

At what age is it recommended?

And if I want a subtle, non-surgical change?