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The idea that traction on the subcutaneous musculoaponeurotic system (SMAS) deepens the nasolabial crease has been propagated through the plastic surgery literature. This notion is contrary to the senior author's experience. The purpose of the present study was to investigate the effects of mobilization of the SMAS on the nasolabial fold and crease. Intraoperative examination on the effect of traction on the SMAS was performed. Ten consecutive primary facelift patients underwent facelift procedures with SMAS support. Following mobilization of the SMAS, traction was placed on the SMAS without traction on the skin. In all cases, the nasolabial fold was effaced and the nasolabial crease did not deepen. The authors concluded that traction on the SMAS did not deepen the nasolabial crease.

Analysis of the effects of subcutaneous musculoaponeurotic system facial support on the nasolabial crease