{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:46:30Z","timestamp":1788515190424,"version":"build-2803163510"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,5,28]],"date-time":"2020-05-28T00:00:00Z","timestamp":1590624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Suspension of the superficial muscular aponeurotic system (SMAS) is generally believed to be necessary in facelift surgery. Although many techniques have been suggested, all rely on the viscoelastic properties of the SMAS<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The aim of this study was to determine the viscoelastic properties of bursting strength, stress relaxation, and creep in the lateral, mid-cheek, and medial regions of the SMAS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The viscoelastic properties of the SMAS were determined in 12 cadaveric hemifaces. Lateral SMAS was classified as the SMAS overlying the parotid gland; mid-cheek SMAS as anterior to the parotid and overlying the masseter muscle; and medial SMAS as including tissue extending medial from the lateral canthus and ending at the nasolabial fold.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The 3 SMAS regions showed significantly different bursting strengths: 38.9 N for the lateral SMAS, 26.7 N for the mid-cheek SMAS, and 11.9 N for the medial SMAS (P &amp;lt;\u20050.0001). Stress relaxation was similar in all vertical regions with measurements of 54% in the lateral, 48% in the mid-cheek, and 59% in the medial SMAS. Creep was found to be similar in the lateral and mid-cheek SMAS with values of 18% and 19%, respectively. The medial SMAS was noted to have a higher creep at 22%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The lateral SMAS has a stronger bursting strength than the mid-cheek and medial SMAS. Creep appears to be lower in the lateral and mid-cheek SMAS. Stress relaxation appears to be similar in all 3 vertical regions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/asj\/sjaa140","type":"journal-article","created":{"date-parts":[[2020,5,28]],"date-time":"2020-05-28T14:51:55Z","timestamp":1590677515000},"page":"277-283","source":"Crossref","is-referenced-by-count":9,"title":["Identifying Regional Viscoelastic Properties of the Superficial Muscular Aponeurotic System"],"prefix":"10.1093","volume":"41","author":[{"given":"Robert","family":"Lukavsky","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, University of Texas Southwestern, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Trussler","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University of Texas Southwestern, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Fritz E","family":"Barton","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University of Texas Southwestern, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, University of Texas Southwestern, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,5,28]]},"reference":[{"issue":"1","key":"2021021215523074000_CIT0001","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.wjorl.2015.12.001","article-title":"Evolution of the rhytidectomy","volume":"2","author":"Barrett","year":"2016","journal-title":"World J Otorhinolaryngol Head Neck Surg."},{"key":"2021021215523074000_CIT0002","article-title":"Surgery for excess","volume-title":"Transactions of the Second International Congress of Plastic and Reconstructive Surgery","author":"Aufricht","year":"1960"},{"key":"2021021215523074000_CIT0003","first-page":"300","article-title":"The aging face","volume-title":"Plastic Surgery: New Methods and Refinements","author":"Skoog","year":"1974"},{"issue":"1","key":"2021021215523074000_CIT0004","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1097\/00006534-197607000-00013","article-title":"The superficial musculo-aponeurotic system (SMAS) in the parotid and cheek area","volume":"58","author":"Mitz","year":"1976","journal-title":"Plast Reconstr Surg."},{"issue":"7","key":"2021021215523074000_CIT0005","doi-asserted-by":"crossref","first-page":"1910","DOI":"10.1097\/01.PRS.0000091420.04613.0A","article-title":"The high-superficial musculoaponeurotic system technique in facial rejuvenation: an update","volume":"112","author":"Barton","year":"2003","journal-title":"Plast Reconstr Surg."},{"issue":"4","key":"2021021215523074000_CIT0006","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1007\/s002669900113","article-title":"Viscoelastic properties of the superficial musculoaponeurotic system (SMAS): a microscopic and mechanical study","volume":"21","author":"Har-Shai","year":"1997","journal-title":"Aesthetic Plast Surg."},{"issue":"3","key":"2021021215523074000_CIT0007","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1097\/PRS.0b013e3182221354","article-title":"The viscoelastic properties of the SMAS and its clinical translation: firm support for the high-SMAS rhytidectomy","volume":"128","author":"Trussler","year":"2011","journal-title":"Plast Reconstr Surg."},{"issue":"2","key":"2021021215523074000_CIT0008","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1067\/msy.2002.118709","article-title":"Adenovirus vector-mediated transfer of the vascular endothelial growth factor cDNA to healing abdominal fascia enhances vascularity and bursting strength in mice with normal and impaired wound healing","volume":"131","author":"Ailawadi","year":"2002","journal-title":"Surgery."},{"issue":"7","key":"2021021215523074000_CIT0009","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1177\/000313480707300718","article-title":"Bursting strength evaluation in an experimental model of incisional hernia","volume":"73","author":"Lucha","year":"2007","journal-title":"Am Surg."},{"issue":"6","key":"2021021215523074000_CIT0010","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1001\/archopht.1975.01010020442009","article-title":"Scleral bursting strength. 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