Foundations
The Technical Principles
Six foundations that guide every surgical decision. Not rules to follow blindly — principles to understand and apply.
Principles are not restrictions. They are freedoms. When you understand why we do something, you don't need to memorize every step. You can adapt, improvise, evolve — always within boundaries that guarantee safety.
Direct Vision Over Endoscopy
Direct vision provides simultaneous tactile and visual feedback. You see AND feel. At the same time. In the same plane. The endoscope creates a dissociation between eye and hand that increases risk and extends the learning curve.
Simultaneous feedback
Vertical Vector, Not Lateral
Gravity pulls down. The solution is to elevate vertically. Lateral vectors create unnatural tension and compromise durability. The vertical vector respects facial anatomy and produces results that last.
Lift against gravity
Preservation Over Resection
Remove less, reposition more. Aggressive resection creates irreversible problems. Intelligent repositioning preserves tissue and allows adjustments. What is removed cannot be put back.
Reposition, don't remove
Safe Deep Plane
The sub-SMAS plane is safer than it seems — when you know the anatomy. The danger is not in the plane, but in ignorance. With correct knowledge, the deep plane offers superior and safer results.
Knowledge is safety
Recovery as a Metric
Quick recovery is not a luxury — it's a sign of good technique. Less trauma, less edema, faster return. If your patient needs 30 days to recover, the technique can be refined.
7 days, not 30
Systematic Reproducibility
If it cannot be taught, it's not a method. Reproducibility is the test of truth. Talent is not scalable; method is. What works for one must work for many.
Method over talent
"Principles are not restrictions. They are freedom to operate without fear."
— Dr. Robério Brandão
See the Principles in Action
Explore the specific techniques that apply these principles.
Explore Techniques