{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T02:30:11Z","timestamp":1790994611028,"version":"4.1.0"},"reference-count":29,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Radiol Bras"],"abstract":"<jats:p>Abstract The superficial musculoaponeurotic system (SMAS) is a complex fibrous network connecting facial muscles to the dermis, with varying morphological characteristics across different facial regions. Recent studies have identified five distinct types of SMAS morphology, highlighting the need for region-specific interventions in facial rejuvenation. This pictorial essay explores ultrasound imaging of the SMAS using ultra-high frequency (24\u201333 MHz) probes, known as U-SMAS. Analysis of 186 full-face U-SMAS scans revealed consistent patterns in the facial and neck layers, with regional variations aligning with the Sandulescu classifications: type I (preparotideal); type II (chin and lip); type III (eyelid); type IV (temporal and parotideal); and type V (cervical). Understanding these morphological differences is crucial for accurate interpretation of ultrasound images and for optimizing pre-procedural assessments to ensure that aesthetic treatments are safe and effective. Knowledge of the SMAS architecture enhances the ability to visualize facial and neck anatomy accurately, particularly through U-SMAS imaging, ensuring comprehensive patient care in rejuvenation procedures.<\/jats:p>","DOI":"10.1590\/0100-3984.2024.0035","type":"journal-article","created":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T07:45:52Z","timestamp":1726818352000},"source":"Crossref","is-referenced-by-count":8,"title":["U-SMAS: ultrasound findings of the superficial musculoaponeurotic system"],"prefix":"10.1590","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5229-8596","authenticated-orcid":false,"given":"Luciana C.","family":"Zattar","sequence":"first","affiliation":[{"name":"Hospital S\u00edrio-Liban\u00eas,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0754-2019","authenticated-orcid":false,"given":"Gladstone","family":"Faria","sequence":"additional","affiliation":[{"name":"Instituto Boggio,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5139-0243","authenticated-orcid":false,"given":"Ricardo","family":"Boggio","sequence":"additional","affiliation":[{"name":"Instituto Boggio,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2024]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"ojad043","DOI":"10.1093\/asjof\/ojad043","article-title":"Objective analysis of age-related changes in the superficial musculoaponeurotic system in Japanese females using computed tomography","volume":"5","author":"Okuda I","year":"2023","journal-title":"Aesthet Surg J Open Forum"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1007\/s00266-003-3065-3","article-title":"Anatomy of the SMAS revisited","volume":"27","author":"Ghassemi A","year":"2003","journal-title":"Aesthetic Plast Surg"},{"key":"ref3","series-title":"StatPearls [Internet]","volume-title":"Anatomy, skin, superficial musculoaponeurotic system (SMAS) fascia","author":"Whitney ZB","year":"2024"},{"key":"ref4","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 V","year":"1976","journal-title":"Plast Reconstr Surg"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1097\/SCS.0000000000004585","article-title":"Superficial fascia in the cheek and the superficial musculoaponeurotic system","volume":"29","author":"Hwang K","year":"2018","journal-title":"J Craniofac Surg"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.aanat.2018.02.007","article-title":"Morphological analysis and three-dimensional reconstruction of the SMAS surrounding the nasolabial fold","volume":"217","author":"Sandulescu T","year":"2018","journal-title":"Ann 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explored","volume":"2013","author":"Broughton M","year":"2013","journal-title":"Anat Res Int"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1111\/jocd.13089","article-title":"Lifting vs volumizing \u2013 the difference in facial minimally invasive procedures when respecting the line of ligaments","volume":"18","author":"Casabona G","year":"2019","journal-title":"J Cosmet Dermatol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.2147\/CCID.S294812","article-title":"Treating aging changes of facial anatomical layers with hyaluronic acid fillers","volume":"14","author":"Kapoor KM","year":"2021","journal-title":"Clin Cosmet Investig Dermatol"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.cps.2008.02.003","article-title":"Surgical anatomy of the midcheek: facial layers, spaces, and the midcheek segments","volume":"35","author":"Mendelson BC","year":"2008","journal-title":"Clin Plast Surg"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.fsc.2022.01.006","article-title":"The fascias of the forehead and temple aligned\u2014an anatomic narrative review","volume":"30","author":"Ingallina F","year":"2022","journal-title":"Facial Plast Surg Clin North Am"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1111\/ddg.13737","article-title":"Anatomy of the facial fat compartments and their relevance in aesthetic surgery","volume":"17","author":"Cotofana S","year":"2019","journal-title":"J Dtsch Dermatol Ges"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"e3755","DOI":"10.1097\/GOX.0000000000003755","article-title":"Neuromodulating the SMAS for natural dynamic results","volume":"9","author":"Corduff N","year":"2021","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1177\/1090820X13495405","article-title":"Retaining ligaments of the 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implications for rhytidectomy","volume":"28","author":"Sykes JM","year":"2020","journal-title":"Facial Plast Surg Clin North Am"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1007\/s00266-013-0066-8","article-title":"Anatomic study of the retaining ligaments of the face and applications for facial rejuvenation","volume":"37","author":"Mendelson BC","year":"2013","journal-title":"Aesthetic Plast Surg"}],"container-title":["Radiologia Brasileira"],"original-title":["U-SMAS: achados ultrassonogr\u00e1ficos do sistema musculoaponeur\u00f3tico superficial"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0100-39842024000100401&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T07:45:59Z","timestamp":1726818359000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0100-39842024000100401&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024]]},"references-count":29,"alternative-id":["S0100-39842024000100401"],"URL":"https:\/\/doi.org\/10.1590\/0100-3984.2024.0035","relation":{},"ISSN":["1678-7099"],"issn-type":[{"value":"1678-7099","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024]]},"article-number":"e20240035"}}