To address age-related changes such as excess eyelid skin, fatty bulges around the eyes, a softened oval face, deep forehead lines, surgeons employ a combination of blepharoplasty, SMAS plasty, and endoscopic frontotemporal lifts. This overview reflects insights from a Moscow-based specialist, Vladimir Zlenko, a plastic surgeon and medical scientist whose observations are cited for context on facial rejuvenation options.
“Blepharoplasty, SMAS plasty, and the endoscopic frontotemporal lift are among the three most popular procedures for restoring a youthful facial appearance,” Zlenko explains. These operations are frequently discussed together because they target different facial regions and work best as complementary treatments when the goal is a harmonized outcome.
As per his assessment, the skin around the eyes is particularly delicate, with limited subcutaneous tissue, making this area the first to reveal signs of aging. The periorbital region is often a focal point for patients seeking a brighter, more awake look, and procedures here can produce noticeable improvements without generalized face changes.
Blepharoplasty focuses on the eyelids to correct the periorbital area. It remains one of the most common facial surgeries. The surgeon typically makes precise incisions on the upper and/or lower lids to tighten skin, remove fatty hernias, or subtly modify the eye shape to achieve balance with surrounding features. This intervention can address droopiness, puffiness, and creases that contribute to a tired appearance.
Age-related changes also present as wrinkles around the eyes, on the forehead, and between the brows. Initially, these wrinkles may appear as transient facial lines that fade with rest, but over time they deepen and become more conspicuous. Subtle muscle activity from frequent expressions can accelerate their appearance, sometimes at a relatively young age. The endoscopic frontotemporal lift targets these concerns by smoothing forehead lines and lifting the outer corners of the eyebrows, which can restore a more open and alert expression while maintaining natural results.
The discussion often moves to defining the lower face margins and addressing the chin and neck profile. Procedures aimed at refining the jawline and reducing a double chin are commonly considered as part of a coordinated makeover. In this context, SMAS plastic surgery stands out as a pivotal technique. Performed at the SMAS layer—the connective tissue over the facial muscles—it tightens both skin and muscle layers to counter sagging. The outcome tends to be long-lasting and preserves a natural look, especially when performed by a skilled surgeon who accounts for the individual’s facial structure and soft tissue dynamics.
Beyond the technical steps, patients should understand recovery timelines, potential risks, and realistic expectations. Blepharoplasty typically involves a brief recovery period with swelling and bruising that gradually fades. SMAS procedures require patience as tissue healing progresses, with improvements continuing over several months. Endoscopic approaches usually mean shorter incisions and a quicker initial recovery, though results hinge on precise technique and patient-specific anatomy.
In Canada and the United States, experienced plastic surgeons emphasize a thorough preoperative assessment. This includes evaluating eyelid laxity, the distribution of facial fat, skin quality, and the overall harmony of facial features. A thoughtful plan often entails staged interventions or combining procedures to achieve a cohesive aesthetic that respects ethnic and racial facial characteristics, age, and individual goals.
For anyone considering facial rejuvenation, a consult with a board-certified plastic surgeon is essential. The practitioner will review medical history, discuss risks such as infection, scarring, or changes in sensation, and outline a personalized sequence of steps. The aim is not to create an artificial look, but to restore balance and a refreshed appearance that remains true to the person’s identity.
Overall, the trio of procedures—blepharoplasty, SMAS plasty, and the endoscopic frontotemporal lift—offers a versatile toolkit for redefining the midface, sharpening the jawline, and easing the signs of aging around the eyes and forehead. When selected and performed with precision, these interventions can produce natural results that withstand the test of time and daily life, enabling patients to face the world with renewed confidence. Citations and clinical guidance from specialists in North America and Europe underscore the importance of individualized planning, patient education, and careful postoperative care to maximize safety and satisfaction.