Objective. To analyze modern methods of facial rejuvenation surgery and high superficial muscular aponeurotic system (SMAS) facelift.

Material and methods. We assessed 84 patients who underwent high SMAS facelift. We identified necessary nuances of this technique leading to optimal postoperative results, i.e. features of skin incision, level and width of mobilization, SMAS flap fixation features.

Results. All 84 patients assessed the long-term postoperative result as a good one. Long-term postoperative edema persisted in patients with autoimmune diseases, as well as in patients who had previous cervical lymphadenectomy. The results were normalized in all patients in 6 months after surgery. There were no violations of facial expressions.

Conclusion. To date, high SMAS mobilization is one of the most optimal methods in facial rejuvenation surgery. Skin incision design bordering the scalp in temporal region leads to optimal fixation of this flap parallel to major zygomatic muscle. Stabilization of treatment results is observed in 6 months after surgery.

Keywords. SMAS, high SMAS facelift, rhytidectomy, dissection, plication, augmentation, skin flap, SMAS flap