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'''Superficial muscular aponeurotic system''' (or '''superficial musculoaponeurotic system'''<ref name=":02">{{Citation |last1=Bohr |first1=Colin |title=Anatomy, Head and Neck, Temporoparietal Fascia |date=2023 |url=http://www.ncbi.nlm.nih.gov/books/NBK507912/ |work=StatPearls |access-date=2023-07-27 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=29939689 |last2=Bajaj |first2=Jitin |last3=Soriano |first3=Roberto M. |last4=Shermetaro |first4=Carl}}</ref>) ('''SMAS''') is a thin yet tough<ref name=":0">{{Cite book |title=Sobotta Anatomy Textbook: English Edition with Latin Nomenclature |publisher=Elsevier |year=2018 |isbn=978-0-7020-6760-0 |editor-last=Waschke |editor-first=Jens |edition=1st |location=München |pages= |editor-last2=Böckers |editor-first2=Tobias M. |editor-last3=Paulsen |editor-first3=Friedrich |editor-last4=Arnold |editor-first4=Wolfgang |editor-last5=Bechmann |editor-first5=Ingo}}</ref>{{Rp|page=438}} unitary tissue plane of the face<ref name=":332">{{Cite book |last=Standring |first=Susan |url=https://www.worldcat.org/oclc/1201341621 |title=Gray's Anatomy: The Anatomical Basis of Clinical Practice |year=2020 |isbn=978-0-7020-7707-4 |edition=42nd |location=[New York] |pages=608 |oclc=1201341621}}</ref> formed by facial fasciae, subcutis connective tissue, and facial muscles.<ref name=":0" />{{Rp|page=438}} Its composition varies, containing muscle fibres in some areas, and fibrous or fibroaponeurotic tissue in others.<ref name=":332" /> It connects to the dermis via vertical septa.{{Citation needed|date=June 2023}} It does not attach to bone. In most areas, a distinct plane can be defined deep to the SMAS (continuous with that formed between the platysma and underlying [[investing layer of deep cervical fascia]]).<ref name=":332" />
{{dablink|For the [[Super NES]] game, see [[Super Mario All-Stars]].}}


Superiorly, the SMAS extends to the [[galea aponeurotica]] of{{Citation needed|date=June 2023}} the scalp,<ref name=":0" />{{Rp|page=438}} becoming continuous with [[temporoparietal fascia]]<ref name=":02"/>'''<ref name=":02"/>''' (at the [[zygomatic arch]]<ref name=":02"/>) and galea.{{Citation needed|date=June 2023}} It becomes continuous with the [[platysma muscle]] inferiorly (inferior to the inferior border of the mandible), and indistinct laterally (inferior to the [[zygomatic arch]]). Anteromedially, it blends with the [[epimysium]] of some facial muscles;<ref name=":332" /> a link between facial muscles and the skin of the face is thereby established, enabling [[facial expression]].<ref name=":0" />{{Rp|page=429}} Over the parotid gland, the SMAS is firmly united with the superficial layer of [[parotid fascia]].<ref name=":33">{{Cite book |last=Standring |first=Susan |url=https://www.worldcat.org/oclc/1201341621 |title=Gray's Anatomy: The Anatomical Basis of Clinical Practice |year=2020 |isbn=978-0-7020-7707-4 |edition=42nd |location=[New York] |pages=608–609 |oclc=1201341621}}</ref>
'''SMAS''' is an [[acronym]] for Superficial Muscular Aponeurotic System. It refers to an area of [[muscle|musculature]] of the face. This muscular system is manipulated during [[facial]] [[cosmetic surgery]] and is often performed as part of a [[rhytidectomy]] or face-lift.


== Clinical significance ==
==See also==
The SMAS is clinically important in [[facial]] [[plastic surgery]] for [[rhytidectomy|rhytidectomy (facelift procedure)]]. During this procedure, the SMAS is accessed through an arch-shaped incision anterior to the ear; a portion of the SMAS is then excised and the remaining SMAS is stretched by drawing it posterior-ward and suturing it, thus making the skin of the face which overlies the SMAS taut.<ref name=":0" />{{Rp|page=438}}
* [[Body modification]]

* [[MACS]]
== References ==
* [[Plastic surgery]]
{{Reflist}}


==External links==
==External links==
* [http://www.emedicine.com/plastic/topic50.htm Facelift, SMAS Plication]
* [http://www.emedicine.com/plastic/topic50.htm Facelift, SMAS Plication]
* [http://www.ukcosmeticsurgery.info UK Cosmetic Surgery Guide] - [http://www.ukcosmeticsurgery.info/nested/facelift Facelift - SMAS (Superficial Muscular Aponeurotic System) Lift - General Information]


{{DEFAULTSORT:Superficial Muscular Aponeurotic System}}
[[Category:Plastic surgery]]
[[Category:Oral and maxillofacial surgery]]
[[Category:Otorhinolaryngology]]


{{muscle-stub}}


{{muscle-stub}}
[[Category:Plastic surgery]]

Latest revision as of 04:29, 25 February 2024

Superficial muscular aponeurotic system (or superficial musculoaponeurotic system[1]) (SMAS) is a thin yet tough[2]: 438  unitary tissue plane of the face[3] formed by facial fasciae, subcutis connective tissue, and facial muscles.[2]: 438  Its composition varies, containing muscle fibres in some areas, and fibrous or fibroaponeurotic tissue in others.[3] It connects to the dermis via vertical septa.[citation needed] It does not attach to bone. In most areas, a distinct plane can be defined deep to the SMAS (continuous with that formed between the platysma and underlying investing layer of deep cervical fascia).[3]

Superiorly, the SMAS extends to the galea aponeurotica of[citation needed] the scalp,[2]: 438  becoming continuous with temporoparietal fascia[1][1] (at the zygomatic arch[1]) and galea.[citation needed] It becomes continuous with the platysma muscle inferiorly (inferior to the inferior border of the mandible), and indistinct laterally (inferior to the zygomatic arch). Anteromedially, it blends with the epimysium of some facial muscles;[3] a link between facial muscles and the skin of the face is thereby established, enabling facial expression.[2]: 429  Over the parotid gland, the SMAS is firmly united with the superficial layer of parotid fascia.[4]

Clinical significance

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The SMAS is clinically important in facial plastic surgery for rhytidectomy (facelift procedure). During this procedure, the SMAS is accessed through an arch-shaped incision anterior to the ear; a portion of the SMAS is then excised and the remaining SMAS is stretched by drawing it posterior-ward and suturing it, thus making the skin of the face which overlies the SMAS taut.[2]: 438 

References

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  1. ^ a b c d Bohr, Colin; Bajaj, Jitin; Soriano, Roberto M.; Shermetaro, Carl (2023), "Anatomy, Head and Neck, Temporoparietal Fascia", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 29939689, retrieved 2023-07-27
  2. ^ a b c d e Waschke, Jens; Böckers, Tobias M.; Paulsen, Friedrich; Arnold, Wolfgang; Bechmann, Ingo, eds. (2018). Sobotta Anatomy Textbook: English Edition with Latin Nomenclature (1st ed.). München: Elsevier. ISBN 978-0-7020-6760-0.
  3. ^ a b c d Standring, Susan (2020). Gray's Anatomy: The Anatomical Basis of Clinical Practice (42nd ed.). [New York]. p. 608. ISBN 978-0-7020-7707-4. OCLC 1201341621.{{cite book}}: CS1 maint: location missing publisher (link)
  4. ^ Standring, Susan (2020). Gray's Anatomy: The Anatomical Basis of Clinical Practice (42nd ed.). [New York]. pp. 608–609. ISBN 978-0-7020-7707-4. OCLC 1201341621.{{cite book}}: CS1 maint: location missing publisher (link)
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