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The retaining ligaments of the face and their importance in facelift surgery

Die Haltebänder des Gesichts und ihre Bedeutung für Facelift-Operationen

Journal für Ästhetische Chirurgie volume 15, pages 22–27 (2022)Cite this article

Abstract

Background

The ability to reposition facial soft tissue and achieve full-face rejuvenation in facelift surgery is unparalleled. A precise and thorough understanding of facial anatomy, the biomechanical properties of its components and the anchoring structures of the facial soft tissue are vital to provide safe, efficient and superlative results.

Objective

This paper aims to summarize the anatomy and importance of the facial retaining ligaments in facelift surgery.

Methods

This narrative review summarizes, from the authors’ experience and research, the anatomy of the facial retaining ligaments and their implications in facelift surgery.

Results

The retaining ligaments of the face are consistent anatomic structures that are present in predictable locations. They divide the soft tissue of the face into spaces and compartments and their release is critical to achieving adequate soft tissue repositioning for a desired aesthetic outcome in facelift surgery. They also serve as helpful and convenient markers for branches of the facial nerve. Some of the facial ligaments of great importance in facelift surgery are the platysma auricular fascia, the zygomatic cutaneous ligament, the masseteric cutaneous ligament and the mandibular cutaneous ligament.

Conclusion

This narrative review highlights the retaining ligaments of the face, their involvement in the structural stability of facial soft tissues and their role in facelift surgery. In order to adequately reposition facial soft tissues, proper release of the facial retaining ligaments is necessary. By understanding the anatomy of these retaining ligaments, plastic surgeons can better achieve safe, satisfactory and enduring results.

Zusammenfassung

Hintergrund

Die Fähigkeit, in der Facelift-Chirurgie Weichgewebe des Gesichts zu repositionieren und eine Verjüngung des gesamten Gesichts zu erzielen, ist unvergleichlich. Ein präzises und gründliches Verständnis der Anatomie des Gesichts, der biomechanischen Eigenschaften seiner Strukturen und der Verankerungsstrukturen des Weichgewebes des Gesichts sind essenziell für sichere, effiziente und hervorragende Ergebnisse.

Ziel

Das Ziel der vorliegenden Arbeit besteht darin, eine Zusammenfassung der Anatomie und Bedeutung der Haltebänder des Gesichts für die Facelift-Chirurgie zu geben.

Methoden

In dieser Übersichtsarbeit werden die Anatomie und die Bedeutung der Haltebänder des Gesichts für die Facelift-Chirurgie gemäß den Erfahrungen und Forschungsergebnissen der Autor*innen dargestellt.

Ergebnisse

Die Haltebänder des Gesichts sind einheitliche anatomische Strukturen, die sich an vorhersehbaren Stellen befinden. Sie unterteilen das Weichgewebe des Gesichts in Räume und Kompartimente, und ihre Lösung ist entscheidend zur Erzielung einer entsprechenden Repositionierung des Weichgewebes für ein gewünschtes ästhetisches Ergebnis der Facelift-Operation. Sie dienen auch als hilfreiche und praktische Marker für Verzweigungen des N. facialis. Einige der Gesichtsligamente von großer Wichtigkeit in der Facelift-Chirurgie sind die Platysma-Ohr-Faszie, die kutanen zygomatischen Ligamente, die kutanen masseterischen Ligamente und das kutane mandibuläre Ligament.

Schlussfolgerung

Die vorliegende Übersichtsarbeit skizziert die Haltebänder des Gesichts, ihre Beteiligung an der strukturellen Stabilität der Weichgewebe des Gesichts und ihre Rolle für die Facelift-Chirurgie. Um eine ausreichende Repositionierung der Weichgewebe des Gesichts zu erzielen, ist die dementsprechende Lösung der Haltebänder des Gesichts notwendig. Mit einem besseren Verständnis der Anatomie dieser Haltebänder können plastische Chirurgen besser sichere, zufriedenstellende und andauernde Ergebnisse erzielen.

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Funding

The authors received no financial support for the research, authorship or publication of this article.

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Authors and Affiliations

  1. Private Practice, New York, NY, USA

    Robert H. Gotkin MD FACS

  2. 625 Park Avenue, 10065, New York, NY, USA

    Robert H. Gotkin MD FACS

  3. Department for Hand, Plastic and Aesthetic Surgery, Ludwig—Maximilian University Munich, Munich, Germany

    Michael G. Alfertshofer & Konstantin Frank

  4. Department of Clinical Anatomy, Mayo Clinic College of Medicine and Science, Rochester, MN, USA

    Sebastian Cotofana

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  1. Robert H. Gotkin MD FACS
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Correspondence to Robert H. Gotkin MD FACS.

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R.H. Gotkin, M.G. Alfertshofer, K. Frank and S. Cotofana declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case.

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Sebastian Cotofana, Rochester, USA

Konstantin Frank, München

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Gotkin, R.H., Alfertshofer, M.G., Frank, K. et al. The retaining ligaments of the face and their importance in facelift surgery. J Ästhet Chir 15, 22–27 (2022). https://doi.org/10.1007/s12631-021-00283-9

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