There are multiple tissue dissection techniques that can be used during a SMAS facelift, but the most notable are the “lamellar” dissections and “Skoog” or “composite.”
During a Skoog or composite dissection, the skin and SMAS are lifted up as one unit and pulled in the same direction. This technique can be performed more quickly and results in a stronger flap that is composed of both SMAS and skin.
Potential problems with this type of dissection are that the SMAS and skin age differently and can move in somewhat different directions as they age. Therefore, moving the skin and the SMAS in exactly the same direction can limit the options of the surgeon as well as the quality of the result.
During a lamellar dissection, the skin and SMAS are lifted up as individual layers and moved in two directions along different routes. One of the advantages of a lamellar dissection is that the SMAS and skin can be moved in somewhat different directions and with different levels of tension, allowing each layer to be moved optimally to create the best result. The downside to this technique is that it is more time-consuming and can be technically challenging.
