medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2026-3-115-117medalphabet-4964Research ArticleСтатьиКомбинированные протоколы трехмерного омоложения лицаCombined 3D facial rejuvenation correctionhttps://orcid.org/0000-0002-2249-5441КругликЕ. В.KruglikE. V.

Круглик Екатерина Владимировна, врач-косметолог, пластический хирург 

Калининград

Kruglik Ekaterina V., cosmetologist, plastic surgeon 

Kaliningrad 

ekaterinakruglik@mail.ruhttps://orcid.org/0000-0003-1866-1993КругликС. В.KruglikS. V.

Круглик Сергей Викторович, к.м.н., пластический хирург 

Калининград; Москва 

Kruglik Sergey V., PhD Med Sci, plastic surgeon 

Kaliningrad; Moscow 

Сеть клиник пластической хирургии и косметологии «VIP clinic»РоссияNetwork of Plastic Surgery and Cosmetology Clinics “VIP Clinic”Russian FederationСеть клиник пластической хирургии и косметологии «VIP clinic» ; АО «Институт пластической хирургии и косметологии»РоссияNetwork of Plastic Surgery and Cosmetology Clinics “VIP Clinic” ; Institute of Plastic Surgery and CosmetologyRussian Federation20261404202603Дерматология (1)115117Copyright © Круглик Е.В., Круглик С.В., 20262026Круглик Е.В., Круглик С.В.Kruglik E.V., Kruglik S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/4964

Современная эстетическая хирургия лица стремится к комплексному восстановлению как положения тканей, так и утраченного объема при коррекции инволютивных изменений. Композитный SMAS-лифтинг (техника Deep Plane) обеспечивает надежную репозицию опущенных глубоких структур, в то время как структурный липофиллинг позволяет корректировать возрастную атрофию жировых компартментов. Выполнение этих процедур в рамках одной операции представляет собой синергичный подход, направленный на достижение максимально естественного и долговременного результата омоложения. В данной статье детально описаны хирургические этапы и технические нюансы комбинированной методики, включая забор, обработку по протоколу Coleman и введение аутологичного жира после выполнения глубокой плоскостной подтяжки. Особое внимание уделено вопросам безопасности, интеграции трансплантата и преимуществам одномоментного выполнения процедуры.

Modern aesthetic facial surgery strives for comprehensive restoration of both tissue position and lost volume during the correction of involutional changes. Composite SMAS lifting (Deep Plane technique) ensures reliable repositioning of sagging deep structures, while structural lipofilling corrects age-related atrophy of fat compartments. Performing these procedures in a single operation represents a synergistic approach aimed at achieving the most natural and long-lasting rejuvenation results. This article describes in detail the surgical stages and technical nuances of the combined technique, including harvesting, processing according to the Coleman protocol, and injection of autologous fat after a deep plane lift. Particular attention is paid to safety, graft integration, and the advantages of a single-stage procedure.

композитный SMAS-лифтингDeep Planeлипофиллингаутологичная трансплантация жираструктурное омоложение лицакомбинированная ритидэктомияcomposite SMAS liftingDeep Plane techniquelipofillingautologous fat graftingstructural facial rejuvenationcombined rhytidectomyReferencesCotofana S., Fratila A.A., Schenck T.L., Redka-Swoboda W., Zilinsky I., Pavicic T. The Anatomy of the Aging Face: A Review. Facial Plast. Surg. 2016; 32: 253–260. DOI: 10.1055/s-0036–1582234Cotofana S., Fratila A.A., Schenck T.L., Redka-Swoboda W., Zilinsky I., Pavicic T. The Anatomy of the Aging Face: A Review. Facial Plast. Surg. 2016; 32: 253–260. DOI: 10.1055/s-0036–1582234Shah A. R., Kennedy P. M. The Aging Face. Med. Clin. N. Am. 2018; 102: 1041–1054. DOI: 10.1016/j.mcna.2018.06.006Shah A. R., Kennedy P. M. The Aging Face. Med. Clin. N. Am. 2018; 102: 1041–1054. DOI: 10.1016/j.mcna.2018.06.006Stein M.J., Aston S.J. Ancillary Procedures to Facelift Surgery: What has Changed? Aesthet. Surg. J. Open Forum. 2023; 5: ojad063. DOI: 10.1093/asjof/ojad063Stein M.J., Aston S.J. Ancillary Procedures to Facelift Surgery: What has Changed? Aesthet. Surg. J. Open Forum. 2023; 5: ojad063. DOI: 10.1093/asjof/ojad063Coleman S.R. Structural fat grafts: the ideal filler? Clin Plast Surg. 2001; 28 (1): 111–119.Coleman S.R. Structural fat grafts: the ideal filler? Clin Plast Surg. 2001; 28 (1): 111–119.Corduff N. Surgical or Nonsurgical Facial Rejuvenation: The Patients’ Choice. Plast. Reconstr. Surg. Glob. Open. 2023; 11: e5318. DOI: 10.1097/GOX.0000000000005318Corduff N. Surgical or Nonsurgical Facial Rejuvenation: The Patients’ Choice. Plast. Reconstr. Surg. Glob. Open. 2023; 11: e5318. DOI: 10.1097/GOX.0000000000005318Mirra C., Savani L., Botti C., Botti G. Our 40 Years’ Experience on Face and Neck Lift Procedures with High-SMAS Flap Techniques: How to Manage Secondary and Tertiary Surgeries. Aesthet. Plast. Surg. 2025; 49: 462–469. DOI: 10.1007/s00266-024-04400-8Mirra C., Savani L., Botti C., Botti G. Our 40 Years’ Experience on Face and Neck Lift Procedures with High-SMAS Flap Techniques: How to Manage Secondary and Tertiary Surgeries. Aesthet. Plast. Surg. 2025; 49: 462–469. DOI: 10.1007/s00266-024-04400-8Hashem A.M., Couto R.A., Duraes E.F., Çakmakoğlu Ç., Swanson M., Surek C., Zins J.E. Facelift Part I: History, Anatomy, and Clinical Assessment. Aesthet. Surg. J. 2020; 40: 1–18. DOI: 10.1093/asj/sjy326Hashem A.M., Couto R.A., Duraes E.F., Çakmakoğlu Ç., Swanson M., Surek C., Zins J.E. Facelift Part I: History, Anatomy, and Clinical Assessment. Aesthet. Surg. J. 2020; 40: 1–18. DOI: 10.1093/asj/sjy326Jalalabadi F., Rohrich R.J. The 10–7 Facial Analysis Method for Face Lifting and Facial Rejuvenation. Plast. Reconstr. Surg. 2024; 154: 275e-282e. DOI: 10.1097/PRS.0000000000010739Jalalabadi F., Rohrich R.J. The 10–7 Facial Analysis Method for Face Lifting and Facial Rejuvenation. Plast. Reconstr. Surg. 2024; 154: 275e-282e. DOI: 10.1097/PRS.0000000000010739Minelli L., van der Lei B., Mendelson B.C. The Superficial Musculoaponeurotic System: Does It Really Exist as an Anatomical Entity? Plast. Reconstr. Surg. 2024; 153: 1023–1034. DOI: 10.1097/PRS.0000000000010557Minelli L., van der Lei B., Mendelson B.C. The Superficial Musculoaponeurotic System: Does It Really Exist as an Anatomical Entity? Plast. Reconstr. Surg. 2024; 153: 1023–1034. DOI: 10.1097/PRS.0000000000010557Mitz V., Peyronie M. The superficial musculo-aponeurotic system (SMAS) in the parotid and cheek area. Plast. Reconstr. Surg. 1976; 58: 80–88. DOI: 10.1097/00006534-197607000-00013Mitz V., Peyronie M. The superficial musculo-aponeurotic system (SMAS) in the parotid and cheek area. Plast. Reconstr. Surg. 1976; 58: 80–88. DOI: 10.1097/00006534-197607000-00013Andretto Amodeo C., Eggerstedt M., Kim I.A., Nabili V., Keller G.S. The Deep Fascia of the Infraorbital Region, Deep Plane, and Suprafibromuscular Facelift: New Anatomy for Safer Facelifting. Facial Plast. Surg. 2022; 38: 623–629. DOI: 10.1055/s-0042–1756456Andretto Amodeo C., Eggerstedt M., Kim I.A., Nabili V., Keller G.S. The Deep Fascia of the Infraorbital Region, Deep Plane, and Suprafibromuscular Facelift: New Anatomy for Safer Facelifting. Facial Plast. Surg. 2022; 38: 623–629. DOI: 10.1055/s-0042–1756456Stuzin J.M., Baker T.J., Gordon H.L. The relationship of the superficial and deep facial fascias: Relevance to rhytidectomy and aging. Plast. Reconstr. Surg. 1992; 89: 441–449. DOI: 10.1097/00006534-199203000-00007Stuzin J.M., Baker T.J., Gordon H.L. The relationship of the superficial and deep facial fascias: Relevance to rhytidectomy and aging. Plast. Reconstr. Surg. 1992; 89: 441–449. DOI: 10.1097/00006534-199203000-00007Minelli L., van der Lei B., Mendelson B.C. The Deep Fascia of the Head and Neck Revisited: Relationship with the Facial Nerve and Implications for Rhytidectomy. Plast. Reconstr. Surg. 2024; 153: 1273–1288. DOI: 10.1097/PRS.0000000000010556Minelli L., van der Lei B., Mendelson B.C. The Deep Fascia of the Head and Neck Revisited: Relationship with the Facial Nerve and Implications for Rhytidectomy. Plast. Reconstr. Surg. 2024; 153: 1273–1288. DOI: 10.1097/PRS.0000000000010556O’Brien J.X., Rozen W.M., Whitaker I.S., Ashton M.W. Lore’s fascia and the platysma-auricular ligament are distinct structures. J. Plast. Reconstr. Aesthet. Surg. 2012; 65: e241–e245. DOI: 10.1016/j.bjps.2012.03.007O’Brien J.X., Rozen W.M., Whitaker I.S., Ashton M.W. Lore’s fascia and the platysma-auricular ligament are distinct structures. J. Plast. Reconstr. Aesthet. Surg. 2012; 65: e241–e245. DOI: 10.1016/j.bjps.2012.03.007Fang A.H., de la Torre J. A Systematic Review of Rhytidectomy Complications and Prevention Methods: Evaluating the Trends. Ann. Plast. Surg. 2025; 94 ((Suppl. S4)): S502–S516. DOI: 10.1097/SAP.0000000000004272Fang A.H., de la Torre J. A Systematic Review of Rhytidectomy Complications and Prevention Methods: Evaluating the Trends. Ann. Plast. Surg. 2025; 94 ((Suppl. S4)): S502–S516. DOI: 10.1097/SAP.0000000000004272Eto H., Suga H., Matsumoto D., et al. Characterization of structure and cellular components of aspirated and excised adipose tissue. Plast. Reconstr. Surg. 2009; 124 (4): 1087–1097.Eto H., Suga H., Matsumoto D., et al. Characterization of structure and cellular components of aspirated and excised adipose tissue. Plast. Reconstr. Surg. 2009; 124 (4): 1087–1097.Khouri R.K., Rigotti G., Cardoso E., et al. Tissue-engineered breast reconstruction with Brava-assisted fat grafting: a 7-year, 488-patient, multicenter experience. Plast Reconstr Surg. 2015; 135 (3): 643–658.Khouri R.K., Rigotti G., Cardoso E., et al. Tissue-engineered breast reconstruction with Brava-assisted fat grafting: a 7-year, 488-patient, multicenter experience. Plast Reconstr Surg. 2015; 135 (3): 643–658.Klein J.A. The tumescent technique for liposuction surgery. Am J Cosmet Surg. 1987;4(4):263–267.Klein J.A. The tumescent technique for liposuction surgery. Am J Cosmet Surg. 1987;4(4):263–267.Illouz Y. G. Body contouring by lipolysis: A 5-year experience with over 3000 cases. Plast Reconstr Surg. 1983; 72 (5): 591–597.Illouz Y. G. Body contouring by lipolysis: A 5-year experience with over 3000 cases. Plast Reconstr Surg. 1983; 72 (5): 591–597.Nayak L.M., Linkov G. Social Media Marketing in Facial Plastic Surgery: What Has Worked? Facial Plast. Surg. Clin. N. Am. 2019; 27: 373–377. DOI: 10.1016/j.fsc.2019.04.002Nayak L.M., Linkov G. Social Media Marketing in Facial Plastic Surgery: What Has Worked? Facial Plast. Surg. Clin. N. Am. 2019; 27: 373–377. DOI: 10.1016/j.fsc.2019.04.002

The authors declare that there are no conflicts of interest present.