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.

Episode 34: Facelift Complications — Every Nerve, Every Danger Zone, and Exactly What Goes Wrong When You Go Too Deep

Three symptoms. Three nerves. Three completely different anatomical stories — and only one of them needs to be seen today.McKinney's Point, the five danger zones, the temporal branch on the deep temporalis fascia, the marginal mandibular branch dipping below the mandible, Stensen's duct across the masseter, the external jugular vein in the posterior triangle, and why the buccal branch almost always recovers while the marginal mandibular keeps you up at night. Episode 34 — facelift complications, from the nerve map to the phone call at one week.

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

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.

Episode 32: Peels and Lasers — Skin Resurfacing, Photodamage, and the Depth That Determines Everything

The facelift fixed the structure. The laser fixes the surface. Without both, you have only done half the job.Fitzpatrick classification, peel depth and frosting levels, phenol cardiotoxicity, fractionated versus fully ablative CO2, PIH in darker skin types, HSV reactivation in an open wound, and the laser eye injury that is always preventable and never forgivable. Episode 32 — peels and lasers, from the Glogau classification to the SPF 50 that must be worn forever.

Episode 31: Alloplastic Breast Reconstruction — Implants, Expanders, ADM, and the Foreign Body in a Mastectomy Field

A foreign body in a mastectomy field. Ischaemic skin flaps. And the radiotherapy that hasn't happened yet but will change everything if it does. ADM anatomy, DTI versus two-stage expander, pre-pectoral versus submuscular placement, radiation-induced contracture, animation deformity, infected implant removal, and the conversion to autologous reconstruction that nobody plans for but everyone eventually needs. Episode