The Plastic Surgery Room

Episode 33: The SMAS — Anatomy, Techniques, and Why the Layer You Choose Determines Everything About the Facelift Result

22 min · 19 de jun de 2026
Portada del episodio Episode 33: The SMAS — Anatomy, Techniques, and Why the Layer You Choose Determines Everything About the Facelift Result

Descripción

Same face. Same ageing. Same surgeon. Two completely different results — because one operation moved the tissue up and the other pulled it back.The SMAS as a system from galea to platysma, the five techniques compared, the retaining ligaments that must be released for true midface correction, the vector of pull that separates a natural result from a pulled look, and the facial nerve that gets closer with every centimetre of deep plane dissection. Episode 33 — the SMAS, from Mitz and Peyronie in 1974 to the deep plane that changed facelift surgery forever.

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Portada del episodio Episode 35: The Anatomy of Facial Ageing — What Falls, What Deflates, What Descends, and How Surgery Puts It Back

Episode 35: The Anatomy of Facial Ageing — What Falls, What Deflates, What Descends, and How Surgery Puts It Back

She holds a photograph of herself at 35 and asks what happened. The answer is six simultaneous processes in six anatomical layers — and surgery addresses only three of them.Skeletal resorption, fat compartment deflation and descent, the six retaining ligaments and exactly what each one does, what fails when it weakens, where it is, and which surgical technique releases it. The zygomatic ligament that creates the nasolabial fold. The masseteric ligament that creates the jowl. The orbitomalar ligament that creates the tear trough. And the pre-jowl sulcus that tells you the mandibular ligament has given up. Episode 35 — the anatomy of facial ageing, from the photograph at 35 to the surgical plan at 58.

19 de jun de 202620 min