Visiting Dr. Tim Marten 2012: San Francisco MCPS

Visiting Dr. Tim Marten 2012:

San Francisco MCPS

This is an original article written by Dr. Minhee Ryu from RNWOOD Plastic Surgery in Seoul, South Korea, translated in English for convenience: 

Dr. Minhee Ryu highlights the influence of Dr. Timothy J. Marten, a leading expert in facelift surgery known for his comprehensive, anatomy-based techniques. Dr. Marten emphasizes addressing the entire facial structure—including the SMAS and retaining ligaments—for natural and long-lasting rejuvenation. His precise methods, teamwork, and deep understanding of facial aging result in balanced, harmonious outcomes. This experience inspired a renewed commitment to patient-centered care and continual refinement of surgical techniques.

Please enjoy the full article below:

When I was a fellow in 2008, I was introduced to Facelift, through the leading expert of this category, Dr. Timothy J. Marten. I read his publications and was shocked: his surgical results were outstanding in comparison to other experts, and the secret behind it remains a subject of contemplation for me to this day. Thanks to a recommendation from a close friend, I was able to experience first-hand his concepts and surgeries. 

Dr. Marten practiced Facelifting at a university hospital at Illinois, Chicago under a fellowship with world-renowned experts such as Dr. Bruce F. Connell, Dr. Baker, Dr. Gorden and Dr. Stuzin. His hospital in San Fransisco is located behind the Union Square building.

He mainly focuses on facelift, neck lift, brow and forehead lift, fat graft and other anti-aging procedures, and has been nominated for titles such as “Top Doctors in America”, “World’s Best Plastic Surgeons”, “World’s Top 5 Address for Plastic Surgery” and “Nationwide Glossary of Experts” under renowned media outlets including the The New York Times. He released a series of notable academic papers about facelifts, forehead lifts and lower-eye wrinkle corrections; when it was confirmed that I was going to be able to visit him, he had sent his written works (that were unavailable in Korea) through the mail for me to study them. Through his immense generosity, I was able to study his surgical techniques and concepts deeper.  Furthermore, he was running a charity organization for children with congenital facial deformities, expressing a desire to help in Korea if assistance was needed. However, he explained that in Korea, many cases are terminated upon prenatal diagnosis, making such patients rare to see. He also noted that Korean charities tend to provide more medical treatment and surgeries abroad than within the country.

When I visited the hospital for the first time, I had the honor of meeting Dr. Matthias Solomon from Minnesota. He had told me he had come to watch Dr.Marten’s surgery. He completed his training at Mayo clinic and is currently practicing at Essentia Health in Duluth. After attending one of Dr.Marten’s academic conferences that left a deep impression, he had come to see Dr. Marten in person. Due to our similar interests in anti-aging cosmetic surgery, we were able to exchange useful information. We were also able to have a more productive and enriching experience during the procedure, as each of us asked questions—often ones the other hadn’t thought of—centered around Dr. Marten.

Dr. Marten’s anti-aging cosmetic surgeries do not just focus on the improvement of one or two areas of the face, but the overall harmony and balance from the face to the neck, which allows for long-lasting improvements.

He explained that it is important to make sure patients looking for a facelift must know that facial aging is an overall phenomenon. Aging affects the face’s upper, lower, middle, and neck; therefore for a natural-looking result, there needs to be an overall improvement for all the areas rather than focusing on just one. Furthermore, it is necessary to properly dissect the retaining ligaments and SMAS in correcting one’s sagging for fundamental and long-lasting results.

His facelift technique involves separating the SMAS and skin layers when pulling them, which allows for natural results. Most patients looking into midface lifting show signs of aging in their lower face and neck, therefore they typically believe that a midface lift. However, Dr.Marten’s method allows for lifting not only the lower face, but also includes the midface.

(Timothy J. Marten. High SMAS Facelift: Combined Single Flap Lifting of the Jawline, Cheek, and Midface. Clin Plastic Surg 35 (2008) 569–603)

Additionally, he dissected the SMAS and retaining ligaments (which directly impacts facial aging) for a sustainable and long-lasting result. His perspective pursues fundamental improvement, therefore he views techniques such as MACS lifts or thread lifts—procedures that do not sufficiently release the SMAS and retaining ligaments—critically. 

(Bryan Mendelson. Facelift anatomy, SMAS, retaining ligaments and facial spaces. Aesthetic Plastic Surgery, SAUNDERS ELSEVIER)

The primary function of the skin is to cover the tissues, it does not bear structural load or support. When adding significant tension on the skin upon lifting procedures for sagging, the patient may experience partial skin necrosis, scarring, ear deformity, unnatural complexion, and other negative side effects. Therefore, Dr.Marten mentioned that in order to properly lift the sagging areas, the retaining ligaments must be dissected as appropriately and an adequate pulling force must be applied on the SMAS (fibromuscular layer beneath the skin). 

My techniques for lifting pursues the same concept. Using Dr. Marten’s methods as foundation for facelifting, I presented a lecture on this topic as one of the panelists for the international scholarly conference hosted by the Korean Society of Plastic and Reconstructive Surgeons.

Dr. Marten aimed at perfecting face lifts and neck lifts. He sought treatment not only for the improvement of the sagging skin on the neck or the bulky fat on the under-chin area, but also the sagging of the submandibular gland and digastric muscle. 

He believed that for an ideal neckline (contour), there should be no bulging between two jawlines. In order to achieve this, the sagging submandibular gland and the prominent digastric muscle needs to be addressed. While most plastic surgeons agree with this concept, the procedure is difficult in its technicality, which is why many surgeons are hesitant to perform it. 

Despite performing a challenging surgery, Dr. Marten took the time to visually demonstrate each structure and explain its significance, repeatedly checking for understanding and encouraging questions. It was impressive how the difficulties of a narrow surgical field and limited visibility were overcome, and the key seemed to be strong teamwork among the members. While the long history of working together likely played a role, what stood out was the clear division of roles between the two assistants and Dr. Marten’s calm, streamlined leadership, which made the complex procedure appear remarkably easy. There was a sense of stability provided by immediate hemostasis, ample lighting, and the precise control by the assistants, allowing for a clear view even in the confined field. It was a reminder that surgery is never a solo act by the surgeon alone. It also left me with a new challenge: how to build such cohesive teamwork with my own team.

The way he performed surgery based on a deep understanding of facial aging and with his own clearly defined concepts was truly impressive. The surgical outcomes, which showed remarkable and fundamental improvements, proved that his concepts were indeed irrefutable.

It made me realize that while skilled hands are important for great surgery, having the insight to analyze the root causes and devise effective solutions is even more crucial. Watching his surgery felt like observing an artist in his own comfort, creating a masterpiece after experiencing a moment of profound inspiration.

To improve sagging eyebrows caused by aging, the main technique used was lifting through small incisions in the scalp, where the retaining ligaments were dissected and released.

(Timothy J. Marten Closed, Nonendoscopic, Small-Incision Forehead Lift. Clin Plastic Surg 35 (2008) 363–378)

However, if symptoms of aging are severe on the patient's upper face or if their hairline is too high, or if skin is too thick/tough, he recommended doing a coronal brow lift first.

(Brow lift through bicoronal incision and forehead lift. From McCord CD Jr. Codner MA. Eyelid & Periorbital Surgery. St.Louis: Quality Medical:2008)

No matter the method of surgery, the target remains the same: to ultimately target the aging of the upper face. Assuming that the surgery is performed correctly, he stated that the differences between surgical techniques ultimately come down to the length of the incision. In the end, the surgeon must prioritize the patient's specific condition when choosing the appropriate technique. Dr. Marten mentioned that he performs the coronal brow lift in about 10% of brow lift cases. His explanations were very helpful in understanding the indications and underlying concepts of each method.

I believe the key to his outstanding and long-lasting results lies in addressing the root causes of aging and improving the entire face in a comprehensive way, thereby achieving harmony and balance. Typically, he performs surgery on one or two patients a day, carefully selecting the best approach based on each patient's condition and circumstance. While he may not operate on a large number of patients, I am confident that those who do undergo surgery with him can expect fundamental improvement and lasting results.

I found myself reflecting on whether I had been trying to fit patients to specific surgical techniques, rather than the other way around. This experience made me reconsider the true essence of each surgical method and reaffirmed my commitment to always place the patient at the center of the decision-making process. To do that, I realized I need to become more fluent and flexible with a wider range of techniques, which will require continued effort and dedication.

While many of the questions I had long held about his exceptional surgical outcomes were resolved to some extent, I also came away with new questions—especially about the application and adaptation of different methods. It feels as though I’m finally beginning to see the shoulders of giants.

Dr. Minhee Ryu, M.D.

RNWOOD Plastic Surgery

Seoul, South Korea

(Source: https://blog.naver.com/rejuvemaster )

Dr. Minhee Ryu is a World-Class FACELIFT Specialist and Global Educator, who is deeply committed to sharing his facial rejuvenation surgery and anatomy expertise. As a lecturer, tutor, and demonstrator, he is invited to deliver DEEP PLANE FACELIFT presentations and perform live surgery and cadaver dissection Demonstrations in more than 15 countries, including Korea, the US, Europe, Singapore, Australia, Japan, and beyond.

Recognized worldwide for his expertise in DEEP PLANE FACELIFT, Dr. Ryu is a Faculty Member at MAFAC since 2016, a guest Faculty Member at Mayo Clinic since 2023, and an Editorial Board Member for the Aesthetic Plastic Surgery Journal (SCI) since 2019. He is an active member of KSPRS, ASPS, ASAPS, and ISAPS. As a global top-tier leader in Facelifts, Dr. Minhee Ryu makes dedicated contributions to academic advancement and surgical education.

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