Historical Context
The Evolution of Facial Surgery
50 years of advances, limitations, and the need for a new approach for 21st century faces.
To understand Modern Face®, we need to understand where we came from. Facial surgery wasn't born ready — it evolved through generations of surgeons who questioned, experimented, and refined. Each era brought advances. Each era left limitations.
What we do today is only possible because giants came before us. But honoring the past doesn't mean blindly repeating it. It means building on it.
The SMAS Era
Skoog, Mitz & Peyronie
Discovery of SMAS as a surgical layer. Beginning of deep plane lifting. Conceptual revolution.
Limitation: Aggressive techniques, long recovery, variable results.
The Deep Plane Era
Hamra
Sub-SMAS deep plane lifting. Longer-lasting results. Improved elevation vector.
Limitation: Extreme learning curve. Risk of nerve injury. Few mastered it.
The Endoscopic Era
Isse, Ramirez
Introduction of the endoscope. Smaller incisions. Magnified visualization.
Limitation: High cost. Loss of tactile feedback. Equipment dependency.
The Filler Era
Various
Explosion of fillers and biostimulators. 'Liquid facelift'. Less surgery.
Limitation: Temporary results. 'Inflated' faces. Alteration of native anatomy.
The Integration Era
Mendelson, Rohrich
Understanding of fat compartments. Combined techniques. Personalization.
Limitation: Increasing complexity. No standardization. Inconsistent results.
The Modern Face® Era
Dr. Robério Brandão
Direct vision. Adaptation for faces with biostimulators. Systematized safety. Shared knowledge.
Limitation: In constant evolution.
What Each Era Taught Us
From SMAS we learned:
That there is a deep layer that sustains results. That pulling only skin doesn't work long-term. That deep anatomy is the secret to durability.
From Deep Plane we learned:
That the sub-SMAS plane is safer than it seems — when you know the anatomy. That less skin tension means better scars. That vertical vectors are superior to lateral ones.
From the endoscopic era we learned:
That smaller incisions are possible. That magnified visualization has value — but also cost. That technology dependency has risks.
From the filler era we learned:
That patients want less invasive procedures. That volume isn't the only answer. And, critically, that biostimulators alter anatomy in ways that old techniques didn't anticipate.
The Modern Face Challenge
Here's the problem: techniques developed between 1970 and 2010 were created for native faces — without biostimulators, without years of hyaluronic acid, without repeated fillers.
Today, 90% of the faces we operate on have already been treated with injectables. The anatomical planes are altered. The fibrosis is different. The risks are different.
Blindly applying 1990s techniques to 2024 faces isn't tradition — it's negligence. Evolution is mandatory.
"Honoring the masters of the past doesn't mean repeating their techniques. It means applying their mindset — of questioning and evolution — to present challenges."
— Dr. Robério Brandão
Why Modern Face®
Modern Face® doesn't discard what came before. It integrates. It takes the best of each era — the understanding of SMAS, the safety of deep plane, the philosophy of minimal invasion — and adapts for today's reality.
It adds what was missing: direct vision as an alternative to the endoscope. Protocols for faces with biostimulators. Systematization of knowledge to shorten the learning curve.
It's not rupture. It's natural evolution. The next chapter of a story that began 50 years ago.
Understand the Technique
See how Modern Face® applies the lessons of the past in the present.
Why Direct Vision?