SMAS Facelift vs. Reflection Lift: What’s the Difference? (Updated 2024)

Mature woman smiling (model)

One of the most popular—and effective—steps to take when considering facelift surgery is to look at a surgeon’s facelift before and after photos. The gallery on the Youthful Reflections Facial Plastic Surgery Center website, for example, includes dozens of photos featuring only a fraction of the more than 3,500 facelift patients I’ve treated at my Nashville practice during my career.

These photos show the results of my comprehensive approach to facelift surgery, combining techniques I’ve developed that optimize outcomes by addressing each patient’s unique anatomy and concerns. The Reflection Lift facelift showcases my unique approach to lifting and securing the SMAS, the superficial muscular aponeurotic system (a layer of fibrous tissue that extends from the neck to the forehead and is made up of collagen, elastin fibers, fat cells, and fascia.)

The effects of aging for most facelift patients extend beyond jowls, sagging neck skin, and other issues addressed by a SMAS facelift. That’s because faces tend to age uniformly, rather than one area at a time. In the images featured in this post, you’ll see examples of facelift before and after photos that include other procedures designed to enhance the results of the Reflection Lift.

What Is a Reflection Lift Facelift?

Performed in an office-based setting using light sedation and local anesthesia, the Reflection Lift eliminates the risks and costs associated with general anesthesia. It is a conservative approach that results in reduced risk of complications and faster recovery than traditional facelift surgery. Most patients show no visibly apparent signs of surgery within 1 to 2 weeks, though patients should allow at least 3 to 4 weeks before any important events.

Here are some Reflection Lift before and after photos without additional procedures:

Facelift / Reflection Lift Case 6 Before & After Front | Nashville, TN | Youthful Reflections
Facelift/Reflection Lift Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 6 Before & After Right Side | Nashville, TN | Youthful Reflections
Facelift/Reflection Lift Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 30 Before & After Front | Nashville, TN | Youthful Reflections
Facelift/Reflection Lift Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 30 Before & After Right Side | Nashville, TN | Youthful Reflections
Facelift/Reflection Lift Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 48 Before & After Front | Nashville, TN | Youthful Reflections
Facelift/Reflection Lift Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 48 Before & After Right Side | Nashville, TN | Youthful Reflections
Facelift/Reflection Lift Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 77 Before & After Front | Nashville, TN | Youthful Reflections
Facelift/Reflection Lift Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 77 Before & After Right Side | Nashville, TN | Youthful Reflections
Facelift/Reflection Lift Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 67 Before & After Front | Nashville, TN | Youthful Reflections
Facelift/Reflection Lift Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 67 Before & After Right Side | Nashville, TN | Youthful Reflections
Facelift/Reflection Lift Before and After by Dr. Boggess in Nashville, Tennessee

Reflection Lift Levels

Each Reflection Lift level addresses the individual patient’s needs:

LEVEL I REFLECTION LIFT

This is a conservative SMAS facelift approach for younger patients that addresses mild to moderate sagging in the jowls and mild sagging in the neck. All properly performed facelift procedures involve some technique for lifting the SMAS to restore a youthful contour to the jawline and neck.

LEVEL II REFLECTION LIFT

This procedure combines a SMAS facelift with liposculpting of the jawline and neck.  It tightens moderate sagging in the jowls and mild to moderate sagging in the neck and removes fat along the jawline and neck.

LEVEL III REFLECTION LIFT

This approach involves a more aggressive mobilization of the SMAS, combined with tightening of the platysma muscle in the midline of the neck and liposculpting of the face and neck.  Dr. Boggess uses this technique if you have moderate to severe sagging in the jowls and neck with associated laxity or banding of the platysma muscle in the front of the neck.

Many men and women who opt for a Level III Reflection Lift often have signs of aging on the upper face and choose to enhance their facelift results with other procedures such as:

Reflection Lift Combined With Eyelid Surgery

Facelift / Reflection Lift Case 27 Before & After Front | Nashville, TN | Youthful Reflections
Facelift/Eyelid Surgery Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 27 Before & After Right Oblique | Nashville, TN | Youthful Reflections
Facelift/Eyelid Surgery Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 12 Before & After Front | Nashville, TN | Youthful Reflections
Facelift/Eyelid Surgery Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 12 Before & After Right Oblique | Nashville, TN | Youthful Reflections
Facelift/Eyelid Surgery Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 49 Before & After Front | Nashville, TN | Youthful Reflections
Facelift/Eyelid Surgery Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 49 Before & After Right Oblique | Nashville, TN | Youthful Reflections
Facelift/Eyelid Surgery Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 113 Before & After Front | Nashville, TN | Youthful Reflections
Facelift/Eyelid Surgery Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 113 Before & After Right Oblique | Nashville, TN | Youthful Reflections
Facelift/Eyelid Surgery Before and After by Dr. Boggess in Nashville, Tennessee

Reflection Lift Combined With Laser Skin Resurfacing

Facelift / Reflection Lift Case 111 Before & After Front | Nashville, TN | Youthful Reflections
Facelift/Laser Skin Resurfacing Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 111 Before & After Right Oblique | Nashville, TN | Youthful Reflections
Facelift/Laser Skin Resurfacing Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 8 Before & After Front | Nashville, TN | Youthful Reflections
Facelift/Laser Skin Resurfacing Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 8 Before & After Right Oblique | Nashville, TN | Youthful Reflections
Facelift/Laser Skin Resurfacing Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 43 Before & After Front | Nashville, TN | Youthful Reflections
Facelift/Laser Skin Resurfacing Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 43 Before & After Right Oblique | Nashville, TN | Youthful Reflections
Facelift/Laser Skin Resurfacing Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 24 Before & After Front | Nashville, TN | Youthful Reflections
Facelift/Laser Skin Resurfacing Before and After by Dr. Boggess in Nashville, Tennessee
Facelift / Reflection Lift Case 24 Before & After Right Oblique | Nashville, TN | Youthful Reflections
Facelift/Laser Skin Resurfacing Before and After by Dr. Boggess in Nashville, Tennessee

Start With a Consultation

If you’re considering a facelift and want a customized, personalized approach that addresses your unique concerns and goals from an experienced, double board-certified facial plastic surgeon in Nashville, request a consultation using the online form or call us at (615) 942-8016 to schedule an appointment.

Originally published May 2018; Updated April 2024

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