The Key to Facial Sagging

Everything About Lifting the “Retaining Ligaments,” the Key to Facial Sagging

Hello.

Mutoel Plastic Surgery

I am Dr. Choi Jun-ho, director.

The hot season has arrived, and as people gradually switch to lighter clothing, many are taking an interest in caring for their appearance.

When looking at yourself in the mirror, the facial contours that appear especially prominent and the loss of elasticity can leave many people feeling distressed.

In the hope of returning to the smooth, firm facial contours they once had, many people actively look into lifting procedures or surgery and visit our clinic.

However, even after receiving expensive and well-known procedures, many people become concerned when the effects are temporary or their face quickly begins to sag again.

They may find themselves wondering, “Why does my face quickly return to how it was even after undergoing lifting treatments diligently?”

Today, we will discuss the “most fundamental and anatomical cause” of facial sagging, as covered directly on Mutoel TV.

I will explain in detail the role of the retaining ligaments deep within the face and the treatments used to correct them.

Are the “retaining ligaments” really the key to lifting?

To give you the conclusion first, the long-term success or failure of facial lifting depends entirely on how these firm support structures are adjusted.

In our faces, there are very firm fibrous tissues that begin at the periosteum of the bones, pass densely through the fascial (SMAS) layer, and extend to beneath the skin.

These are the “retaining ligaments.”

They function much like iron stakes and strong ropes that firmly anchor a tent deep into the ground so that it does not get blown away or collapse in strong winds.

When these strong anchoring structures firmly support the center of the face in various locations, they allow us to maintain elastic, balanced, and smooth facial contours.

In other words, they are the most basic and central axis that determines the three-dimensional appearance of the face.

Schematic diagram of the “retaining ligaments”

However, as aging progresses, collagen and elastin decrease significantly, and the once-firm anchoring ligament structures themselves gradually become loose and elongated.

Ligament structures that have stretched and lost elasticity can no longer hold the tissues above them in place.

Just as the ropes anchoring a tent become loosely undone, their supporting strength is lost and the poles begin to shake uncontrollably.

Eventually, as the firm anchoring force that had supported the tissues gives way, the fat and skin tissues hanging above it collapse downward under the force of gravity.

As a result, the area beneath the eyes becomes puffy and droops, nasolabial folds deepen, and thick bulges develop around the corners of the mouth.

Why does the face sag again if it is simply pulled upward?

It is not difficult to encounter people who feel distressed because their face sagged again not long after receiving expensive thread lifting or facelift surgery.

Although they invested considerable money and time, the reason the results last only a short time can be attributed to the unique anatomical characteristics of the anchoring structures inside the face.

If the “retaining ligament tissue” that firmly supports the structures beneath the skin remains intact, no matter how strongly the skin is pulled with threads, it becomes caught and blocked by the tough “ropes” of the ligaments and cannot move any farther upward.

In other words, if you attempt to forcefully pull only the skin or fascia upward without releasing these firm anchoring structures, the treated area quickly becomes loose because of its tendency to return to its original position.

Unnatural facial expressions or side effects such as depressions in the skin may also occur.

Release and refixation for reliable lifting

Therefore, to achieve “true lifting effects” that last for a long time, treatment must fundamentally address the cause of the loosened anchoring ligaments.

Only after carefully and gently releasing the retaining ligaments whose supporting strength has greatly weakened, and firmly refixing them in a position one layer higher, can a genuine lifting effect be achieved.

In plastic surgery, this is professionally referred to as the process of “retaining ligament release and refixation.”

It is like the simple truth that any building will soon collapse if its weak foundation is not repaired.

In particular, even during lower eyelid surgery, which is performed beneath the eyes, the orbital retaining ligament tissue surrounding the orbit must be properly addressed to reliably prevent the recurrence of under-eye fat protrusion caused by fat pushing out again.

A specialist’s expertise for safe results

The method of making minute structural corrections is an extremely careful and precise procedure closely related to patient safety.

Inside the face, countless microscopic blood vessel networks, sensory nerves, and complex facial nerves that enable free facial expressions are densely intertwined.

If excessive release is performed in an inexperienced or improperly planned manner, the risk of seriously injuring the facial nerves—and consequently causing temporary paralysis or asymmetry in facial expressions—increases significantly.

For this reason, all examinations, procedures, and surgeries should be entrusted safely to a board-certified plastic surgeon who is thoroughly familiar with the internal and external anatomy of your face.

By delicately releasing the retaining ligaments inside the face, we help protect your face more safely and precisely.

In closing..

Mutoel Plastic Surgery, located in Yongsan, pursues natural beauty that harmonizes with each patient’s own complexion and features, rather than an unnatural face that appears overly pulled.

By actively operating a sterilization and aseptic system in the operating rooms, we make safety our top priority by thoroughly eliminating even minor potential sources of external infection in advance.

We provide more accurate treatment through a collaborative system involving three specialists from the fields of plastic surgery, dermatology, and pathology.

This is why we never provide unnecessary overtreatment and instead focus on maximizing harmony.

If you would like to rediscover your unique confidence and original contours that have become disrupted over time, please feel free to knock on our door and begin a consultation with Mutoel.

At Mutoel, where we always offer honesty, we will provide you with natural changes.

This was Dr. Choi Jun-ho.

Thank you.