Combined 3D facial rejuvenation correction
https://doi.org/10.33667/2078-5631-2026-3-115-117
Abstract
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.
About the Authors
E. V. Kruglik
Network of Plastic Surgery and Cosmetology Clinics “VIP Clinic”
Russian Federation
Russian Federation
Kruglik Ekaterina V., cosmetologist, plastic surgeon
Kaliningrad
S. V. Kruglik
Network of Plastic Surgery and Cosmetology Clinics “VIP Clinic” ; Institute of Plastic Surgery and Cosmetology
Russian Federation
Russian Federation
Kruglik Sergey V., PhD Med Sci, plastic surgeon
Kaliningrad; Moscow
References
1. Cotofana 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-0036–1582234
2. Shah A. R., Kennedy P. M. The Aging Face. Med. Clin. N. Am. 2018; 102: 1041–1054. DOI: 10.1016/j.mcna.2018.06.006
3. Stein 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/ojad063
4. Coleman S.R. Structural fat grafts: the ideal filler? Clin Plast Surg. 2001; 28 (1): 111–119.
5. Corduff N. Surgical or Nonsurgical Facial Rejuvenation: The Patients’ Choice. Plast. Reconstr. Surg. Glob. Open. 2023; 11: e5318. DOI: 10.1097/GOX.0000000000005318
6. Mirra 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/s00266-024-04400-8
7. Hashem 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/sjy326
8. Jalalabadi 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.0000000000010739
9. Minelli 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.0000000000010557
10. Mitz V., Peyronie M. The superficial musculo-aponeurotic system (SMAS) in the parotid and cheek area. Plast. Reconstr. Surg. 1976; 58: 80–88. DOI: 10.1097/00006534-197607000-00013
11. Andretto 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-0042–1756456
12. Stuzin 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: 10.1097/00006534-199203000-00007
13. Minelli 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.0000000000010556
14. O’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.2012.03.007
15. Fang 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.0000000000004272
16. 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.
17. 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.
18. Klein J.A. The tumescent technique for liposuction surgery. Am J Cosmet Surg. 1987;4(4):263–267.
19. Illouz Y. G. Body contouring by lipolysis: A 5-year experience with over 3000 cases. Plast Reconstr Surg. 1983; 72 (5): 591–597.
20. 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.2019.04.002
Review
For citations:
Kruglik E.V., Kruglik S.V. Combined 3D facial rejuvenation correction. Medical alphabet. 2026;(3):115-117. (In Russ.) https://doi.org/10.33667/2078-5631-2026-3-115-117
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