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The Complete Facelift Guide

What’s Actually Aging

SMAS, Ligaments, and Fat Pads

To understand a facelift, it helps to understand what’s actually aging, and it isn’t only the skin. The face is built in layers, and time changes each one. A modern facelift works because it treats the right layer.

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Facelift patient of Dr. Lynam in Richmond, before and after

Facelift · Before and After

Individual results vary.

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The Layers of the Face

Skin

The surface. It loses collagen and elasticity, thins, and wrinkles. Important, but it is not what holds the face up, which is why pulling skin alone never lasts.

Fat Compartments

The face isn’t one uniform pad of fat; it’s a set of distinct compartments in the cheeks, midface, and around the mouth. With age these shrink and slide downward, which is why cheeks flatten while folds near the mouth deepen.

The SMAS

The superficial musculoaponeurotic system, a continuous sheet of muscle and connective tissue beneath the fat. In the neck it continues as the platysma muscle. The SMAS is the structural layer of the face, the layer a lasting lift has to reposition.

Retaining Ligaments

Tough anchor points that tether the SMAS and skin to the bone. Over time they let tissue sag along predictable lines, creating jowls and midface descent. Releasing these is central to the deep plane technique.

What actually changes as the face ages, explained by Dr. Lynam in Richmond

What Actually Changes as We Age

Aging is the sum of changes across those layers, in a predictable pattern. Fat compartments deflate and descend, so cheeks flatten and folds deepen. The SMAS loosens and the retaining ligaments give, so jowls form, the midface drops, and the neck slackens. And skin thins and loses elasticity, so it no longer snaps back over the shifting structure beneath.

This is also why faces age in two directions: some accumulate fullness while others deplete and hollow. You can read more about that on our How Your Face Ages page.

A skin-only facelift pulls the top layer over structure that’s still sagging: tight for a while, then loose again. A deep plane facelift works at the level that actually aged. It releases the retaining ligaments and repositions the SMAS and skin together, so the deep structure is restored and the skin simply follows. That’s why the result looks natural and lasts. Learn more about the deep plane facelift.

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Common Questions

What is the SMAS?

The muscular and connective layer beneath the facial fat; the structural layer a lasting facelift repositions.

What are retaining ligaments?

Anchor points tethering facial tissue to bone. They loosen with age and are released in a deep plane lift.

Is aging skin or muscle?

Both, but the sagging that a facelift corrects is mostly in the SMAS, ligaments, and fat, not the skin alone.

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Facelift Videos

A Facelift Patient's Story

Another Patient's Facelift Experience

Choosing Dr. Lynam for Your Facelift

Inside Richmond Surgical Arts

A little over a year ago I decided I wanted me back! I researched doctors and chose Dr. Lynam to do a facelift. I obviously had faith in him, I let him operate on my face! But, that was not all! He did such a fantastic, amazing job, I got a breast reduction in June 2013 to help with the neck and back pain I had suffered for years. To my surprise I actually could breathe better.

– Face Lift / Neck Lift Patient

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The Facial Anatomy of Aging