The trifurcated SMAS flap: three-part segmentation of the conventional flap for improved results in the midface, cheek, and neck.

While SMAS surgery revolutionized facelift procedures, the single flap created by conventional dissections suffers the drawback that it can only be advanced in one direction and sutured in place under uniform tension. Division of the flap into three segments overcomes this problem and allows independent pull to be applied in different directions to the upper midface, cheek, and neck.