The Hidden Support System Behind A Natural Facelift

When facelift surgery is performed, surgeons are lifting tissues that have fallen with gravity. But it is not just the skin that changes with age. The deeper muscle layer beneath the skin also descends over time, and understanding that support layer is essential to understanding how facelift surgery works. In this educational video, board certified facial plastic surgeon Dr. Richard Balikian explains the concept of the facial and neck hammock. He shows how the SMAS begins at the temples, continues through the cheeks, and extends into the neck as the platysma muscle, where it connects into one U shaped hammock of muscle that helps support the face, jawline, and neck. When we are younger, this muscular support layer helps hold the skin and soft tissues up in a higher, more youthful position. As gravity takes over with age, that hammock starts to slide downward. This contributes to jowls in the lower face and separation of the platysma in the center of the neck, which can appear as neck bands. Dr. Balikian explains that both SMAS facelift surgery and deep plane facelift surgery are working to repair this hammock of muscle, but they do so in different ways. In a SMAS facelift, surgeons may tighten the platysma in the center of the neck with a platysmaplasty, elevate the skin, and then lift and secure the deeper support layer. However, he also explains an important limitation of a sub-SMAS facelift. The support layer is tethered down by retaining ligaments, which he describes as Velcro like attachments along the cheek, masseter, jawline, and neck. If those retaining ligaments are not released, lifting the hammock can create a tug of war effect. Surgeons may pull tighter against those fixed attachments, which can create tension, thick scars, pleating, unnatural pulls, and less natural movement through the face. That is why Dr. Balikian explains the value of the deep plane facelift. In a deep plane facelift, surgeons continue further under the support layer and release those retaining attachments so the facial hammock can move more freely and be repositioned more naturally. This video is especially valuable for patients trying to understand how SMAS facelift techniques differ from deep plane facelift techniques, why platysma bands form, why jowls develop, and why ligament release matters in modern facelift surgery. Topics discussed in this video include SMAS anatomy, platysma anatomy, the hammock of muscle concept, jowls, platysma bands, platysmaplasty, retaining ligaments, Velcro like attachments, sub-SMAS facelift, deep plane facelift, and why releasing deeper attachments helps create a more natural result. This video is part of Dr. Balikian’s Facelift Anatomy Series explaining the anatomy behind modern facelift and neck lift surgery. #Facelift #DeepPlaneFacelift #SMASFacelift #Platysma #NeckLift #FacialPlasticSurgery #PlasticSurgeryEducation ------- FACELIFT ANATOMY SERIES BY DR. RICHARD BALIKIAN 3 Facial Layers Facelift Incisions Neck Hammock And Platysma Support Facial Ligaments Deep Structures Beneath The SMAS Platysma Muscle And Neck Bands SMAS Facelift Techniques Vertical Vector Facelift Lifting LEARN MORE ABOUT FACELIFT SURGERY https://www.drbalikiansandiego.com/ed... BALIKIAN FACIAL PLASTIC SURGERY https://www.drbalikiansandiego.com Phone 858-230-8938 CHAPTERS 0:00 Gravity And Facial Aging 0:10 The SMAS And Platysma Hammock 0:35 How Jowls And Neck Bands Form 0:51 How A SMAS Facelift Repairs The Hammock 1:48 Why A Deep Plane Facelift Releases Ligaments