It is commonly believed that facelift surgery lifts skin and tightens facial muscles as well. This is only partially true. The only muscle truly tightened in a facelift is the plastyma muscle of the neck. This is usually split in the midline with age and is sewn back together to get rid of vertical neck bands through a small submental skin incisions. (usually after neck liposuction is first performed)
There are no muscles on the side of the face that can be tightened as they are the chewing muscles (masseter muscles) which don’t sag with age. The tissues below the skin that is tightened on the side of the face is a layer above the muscles known as the SMAS (submusculoaponeurotic system), a fibrofatty tissue layer but not muscle. It is an important tissue layer to manipulate as it is the workhouse of a facelift and avoids excessive skin removal and tension on the skin closure around the ears.
Dr. Barry Eppley
Indianapolis, Indiana