Journal
AESTHETIC SURGERY JOURNAL
Volume 33, Issue 6, Pages 769-782Publisher
OXFORD UNIV PRESS INC
DOI: 10.1177/1090820X13495405
Keywords
retaining ligaments; SMAS; facial compartments; facial nerve; facial surgery; anatomy
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Funding
- Mentor Corp (Santa Barbara, California)
- Syneron Corp (Irvine, California)
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The retaining ligaments of the face are important in understanding concepts of facial aging and rejuvenation. They are located in constant anatomic locations where they separate facial spaces and compartments. Their superficial extensions form subcutaneous septa that separate facial fat compartments. Their main significance relates to their surgical release in order to achieve the desired aesthetic outcome. Furthermore, they have a sentinel role in their anatomic relationship to facial nerve branches. When performing facial aesthetic surgery, plastic surgeons should select a plane of dissection, release the appropriate ligaments depending on the desired aesthetic goals, and avoid nerve injury by using the ligaments as anatomic landmarks. Descriptions of the retaining ligaments are variable in the literature; due to different interpretations of anatomy, several classifications, locations, and nomenclature systems have been proposed. This article will review and clarify the anatomy of the retaining ligaments of the face, including the cheek, mandible, temporal, and periorbital areas.
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