A Continuous Evolution
The history of facial surgery is a story of progressive refinement. From procedures that only removed skin to techniques that reposition deep structures, each generation of surgeons built upon previous knowledge. Understanding this evolution is not just historical curiosity — it helps understand why we do what we do today and where the specialty is heading.
Timeline
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Discoveries that Changed Everything
The Discovery of SMAS (1976)
Mitz and Peyronie identified the Superficial Musculoaponeurotic System — a continuous layer connecting facial expression muscles. They realized that tensioning only the skin was insufficient; the SMAS needed to be manipulated for lasting results.
The Deep Plane Concept (1990)
Sam Hamra introduced the Deep Plane Facelift, dissecting under the SMAS instead of over it. This allowed mobilization of tissues in a single block, with more natural and lasting results — but required advanced anatomical knowledge.
Fat Compartments (2000s)
Understanding that facial fat is organized in discrete compartments revolutionized understanding of aging. It wasn’t just “volume loss” — it was differentiated deflation and ptosis of each compartment.
The Modern Era: New Challenges
The 21st century brought an unexpected challenge: the popularization of biostimulators. Sculptra, Radiesse, Ellansé, and other products changed the anatomy of faces surgeons encounter. Techniques developed for “virgin” faces from treatments didn’t work the same way on faces with biostimulator-induced fibrosis. Anatomical planes were altered, dissection was more difficult, risks were different.
“We were using old maps to navigate new terrain. Modern Face emerged from the need to adapt proven techniques to the anatomical reality of contemporary patients.”
- — Dr. Robério Brandão
The Emergence of Modern Face
The Modern Face philosophy doesn’t reject accumulated knowledge — it adapts it. It recognizes that ~90% of today’s patients have already received some type of injectable treatment, and offers techniques designed for this reality:
Direct Vision Endomidface: Subperiosteal dissection avoiding biostimulator-fibrosed planes
Deep Neck without gland removal: Cervical approach preserving functional structures
No endoscope dependence: Accessible techniques without expensive equipment
The Future of Facial Surgery
If history teaches anything, it’s that the specialty will continue evolving. Current trends suggest:
Less is More
Less invasive techniques with faster recovery.
Personalization
Approaches adapted to each patient’s specific profile.
Integration
Smart combination of surgery and non-invasive procedures.
Naturalness
Focus on results that rejuvenate without “looking operated”.
Related Articles
What is Modern Face?
A deep dive into the philosophy and techniques of the modern era.
Endomidface Guide
Learn about the evolution of the midface lift technique.
Deep Neck Guide
The evolution of cervical rejuvenation from skin to deep structures.
For surgeons: Join the evolution of facial surgery through our [mentorship programs.
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