{"id":13999,"date":"2024-05-14T04:43:51","date_gmt":"2024-05-14T02:43:51","guid":{"rendered":"https:\/\/osteopathie-liem.de\/superficial-musculoaponeurotic-system-fascia-smas-anatomy-and-treatment\/"},"modified":"2024-05-14T04:43:51","modified_gmt":"2024-05-14T02:43:51","slug":"superficial-musculoaponeurotic-system-fascia-smas-anatomy-and-treatment","status":"publish","type":"post","link":"https:\/\/osteopathie-liem.de\/en\/superficial-musculoaponeurotic-system-fascia-smas-anatomy-and-treatment\/","title":{"rendered":"Superficial Musculoaponeurotic System fascia (SMAS): Anatomy and treatment."},"content":{"rendered":"<h2><span style=\"font-weight: 400;\">  SMAS of the superficial fascia of the face:<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">&#8211; Fibroelastic: more thin-layered towards the periphery; in youth, rich in elastic fibers which become progressively less during aging.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; It forms a fibromuscular network in the face region, since all the mimetic muscles are invested and linked via the SMAS.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Thus the SMAS is sometimes seen in phylogenetic terms as a platysma.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; The superficial fascia acts in as a kind of central point of attachment for the mimetic muscles, acting to modulate and transmit muscle tensions and convey movements to the skin.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; In the face region, the superficial adipose tissue is generally thin and interwoven with muscle fibers of the mimetic muscles.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; The deep adipose tissue separates the SMAS from the deep fascia.<br \/>\nHorizontally-running septa act as buffers for the deep-lying muscles.<br \/>\nAnother function is to separate the contractions of the deeply situated masticatory muscles from the superficially lying mimetic muscles.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; The depth of the deep adipose tissue varies.<br \/>\nEspecially in the cheek, it is strong and rich in fat, while in the region of the parotid gland it is absent (here, the SMAS lies directly adjacent to the deep fascia).<br \/>\nIn the region of the zygomatic arch and nasolabial groove it is very thin.<br \/>\nHere, the buccinator and zygomaticus muscles pass through the deep adipose tissue and link the deep and superficial fascia.   <\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8211; Connections:<\/span><span style=\"font-weight: 400;\"> &#8211; Caudad, with the platysma.<\/span><span style=\"font-weight: 400;\"> &#8211; Cephalad, with the epicranial aponeurosis and superficial temporoparietal fascia.<\/span><span style=\"font-weight: 400;\"> &#8211; Toward the surface, with the dermis via the vertical superficial skin ligaments situated in the superficial adipose tissue; the elasticity of these septa and of the superficial fascia reduces in aging, leading to ptosis of the skin.<\/span><span style=\"font-weight: 400;\"> &#8211; Toward deeper-lying regions, with the deep fascia of the face via the horizontal elastic deep skin ligaments in the deep adipose tissue.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"size-large wp-image-13176\" src=\"https:\/\/osteopathie-liem.de\/wp-content\/uploads\/2024\/05\/Superficial-Musculoaponeurotic-System-fascia--571x1024.jpeg\" alt=\"Illustration of a cross-section of a human nose with the following layers: Skin, mucosa, superficial musculo-aponeurotic system, suspensory ligaments, periaosteum and deep fascia. Labels included for convenience.\" width=\"571\" height=\"1024\" srcset=\"https:\/\/osteopathie-liem.de\/wp-content\/uploads\/2024\/05\/Superficial-Musculoaponeurotic-System-fascia--571x1024.jpeg 571w, https:\/\/osteopathie-liem.de\/wp-content\/uploads\/2024\/05\/Superficial-Musculoaponeurotic-System-fascia--167x300.jpeg 167w, https:\/\/osteopathie-liem.de\/wp-content\/uploads\/2024\/05\/Superficial-Musculoaponeurotic-System-fascia--768x1378.jpeg 768w, https:\/\/osteopathie-liem.de\/wp-content\/uploads\/2024\/05\/Superficial-Musculoaponeurotic-System-fascia--856x1536.jpeg 856w, https:\/\/osteopathie-liem.de\/wp-content\/uploads\/2024\/05\/Superficial-Musculoaponeurotic-System-fascia--7x12.jpeg 7w, https:\/\/osteopathie-liem.de\/wp-content\/uploads\/2024\/05\/Superficial-Musculoaponeurotic-System-fascia-.jpeg 960w\" sizes=\"(max-width: 571px) 100vw, 571px\" \/><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-weight: 400;\">Fig.<br \/>\n1 from: <a href=\"https:\/\/plasticsurgerykey.com\/facial-aging-and-anatomy-of-the-facial-nerve\/\" target=\"_blank\" rel=\"noopener\">https:\/\/plasticsurgerykey.com\/facial-aging-and-anatomy-of-the-facial-nerve\/<\/a> <\/span><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Treatment of SMAS<\/strong><span style=\"font-weight: 400;\">Hand position: (Figure 4.23).<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">  Points of connection between superficial and deep fasciae These can be assessed and treated in the region of the zygomatic arch, parotid gland, and anterior masseter muscle (Figure 4.22).<\/span><\/li>\n<\/ul>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The SMAS of the superficial fascia of the face can be treated by mobilization of the mimetic muscles  <\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ask the patient to grimace the face against the resistance of the hands.<br \/>\nThe hands are aligned with the SMAS layer. <\/span><\/li>\n<\/ol>\n<p><img decoding=\"async\" class=\"size-full wp-image-13179\" src=\"https:\/\/osteopathie-liem.de\/wp-content\/uploads\/2024\/05\/Superficial-Musculoaponeurotic-System-fascia-2.jpeg\" alt=\"A medical professional in a blue uniform performs a facial massage on a reclining woman, concentrating on the cheeks and forehead. The massage is considered a treatment of the superficial muscular aponeurotic fascia of the face.\" width=\"710\" height=\"572\" srcset=\"https:\/\/osteopathie-liem.de\/wp-content\/uploads\/2024\/05\/Superficial-Musculoaponeurotic-System-fascia-2.jpeg 710w, https:\/\/osteopathie-liem.de\/wp-content\/uploads\/2024\/05\/Superficial-Musculoaponeurotic-System-fascia-2-300x242.jpeg 300w, https:\/\/osteopathie-liem.de\/wp-content\/uploads\/2024\/05\/Superficial-Musculoaponeurotic-System-fascia-2-15x12.jpeg 15w\" sizes=\"(max-width: 710px) 100vw, 710px\" \/><\/p>\n<p><span style=\"font-weight: 400;\">Check Liem 2023<\/span><a href=\"https:\/\/www.amazon.de\/s?k=Cranial+Osteopathy%3A+Principles+and+Practice+-+Volume+1&amp;__mk_de_DE=%C3%85M%C3%85%C5%BD%C3%95%C3%91&amp;crid=2KZYPBXV265PA&amp;sprefix=cranial+osteopathy+principles+and+practice+-+volume+1%2Caps%2C95&amp;ref=nb_sb_noss\"><span style=\"font-weight: 400;\">https:\/\/www.amazon.de\/s?k=Cranial+Osteopathy%3A+Principles+and+Practice+-+Volume+1&amp;__mk_en_DE=\u00c5M\u00c5\u017d\u00d5\u00d1&amp;crid=2KZYPBXV265PA&amp;sprefix=cranial+osteopathy+principles+and+practice+-+volume+1%2Caps%2C95&amp;ref=nb_sb_noss<\/span><\/a><\/p>\n<p><a href=\"https:\/\/www.amazon.de\/s?k=kraniosakrale+Osteopathie&amp;__mk_de_DE=%C3%85M%C3%85%C5%BD%C3%95%C3%91&amp;crid=1M07AVH5PEC0K&amp;sprefix=kraniosakrale+osteopathie%2Caps%2C85&amp;ref=nb_sb_noss_1\" target=\"_blank\" rel=\"noopener\"><img decoding=\"async\" class=\"wp-image-13177 size-thumbnail\" src=\"https:\/\/osteopathie-liem.de\/wp-content\/uploads\/2024\/05\/Superficial-Musculoaponeurotic-System-fascia-SMAS-150x150.jpeg\" alt=\"Cover of the book \"Cranial Osteopathy: Principles and Practice Volume One\" by Torsten Liem, showing a golden, stylized human face with details of the fascia of the superficial musculoaponeurological system against a black background.\" width=\"150\" height=\"150\"><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The SMAS (superficial musculoaponeurotic system) supports facial muscles and skin.<br \/>\nRich in elastic fibers when young, it diminishes with age, causing sagging.<br \/>\nMobilizing the SMAS through muscle resistance exercises can enhance facial tone, maintaining a youthful appearance.<br \/>\nFor detailed methods, see Liem&#8217;s &#8220;Cranial Osteopathy: Principles and Practice.&#8221;   <\/p>\n","protected":false},"author":3,"featured_media":14002,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":393,"footnotes":""},"categories":[76],"tags":[],"class_list":["post-13999","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-osteopathy"],"acf":[],"_links":{"self":[{"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/posts\/13999","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/comments?post=13999"}],"version-history":[{"count":0,"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/posts\/13999\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/media\/14002"}],"wp:attachment":[{"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/media?parent=13999"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/categories?post=13999"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/osteopathie-liem.de\/en\/wp-json\/wp\/v2\/tags?post=13999"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}