Presentation in Plastic Surgery The Meeting 2017 Orlando
Plastic Surgery The Meeting 2017 Orlando Presentation:
"Facelift Technique for the Management of Soft Tissue Drooping after Facial Bone Contouring Surgery in Asian Patients."
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The academic conference Plastic Surgery The Meeting 2017, hosted by the American Society of Plastic Surgeons (ASPS), was held in Orlando from October 5 to 10. I gave a presentation on "Facelift Technique for the Management of Soft Tissue Drooping after Facial Bone Contouring Surgery in Asian Patients."
East Asians generally tend to have broader and larger facial structures, which has led to the development of various surgical techniques to improve facial proportions. Among the most common are facial bone contouring procedures such as zygomatic (cheekbone) reduction and mandibular angle (jawline) reduction. However, soft tissue drooping often occurs after these surgeries, which can result in a sad or aged appearance. In my presentation, I shared my clinical experience regarding the causes of this issue and effective surgical solutions for improvement.
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The causes of soft tissue drooping after facial bone surgery have been relatively well-documented, and there are several related SCI-indexed publications. In particular, a paper by Prof. Rong-Min Baek of Seoul National University Bundang Hospital was especially helpful in preparing this presentation. Based on these resources, I analyzed the causes from both soft tissue and skeletal perspectives.
The main focus of my presentation, however, was on treatment methods. While the causes of post-contouring drooping have been extensively studied by specialists in facial bone surgery over many years, the improvement has typically been limited to a general recommendation for facelift surgery, with little detailed guidance available.
Facelift procedures come in many forms, and even when the same technique is used, the outcome can vary greatly depending on the surgeon’s experience and expertise. This variability is a key consideration when planning effective treatment.
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| https://rnwoodplasticsurgery.blogspot.com/2016/12/current-trends-and-perspectives-on.html |
After facial contouring surgery, some degree of soft tissue sagging is inevitable, proportional to the amount of bone reduction. Therefore, non-invasive methods like thread lifting, which do not involve tissue excision, often fail to produce satisfactory results. To achieve a noticeable improvement, procedures that include the removal of excess tissue are usually necessary.
Among various surgical options, midface lifting—approached through the temple or lower eyelid—can be considered. This may be effective if sagging is limited to the midface area. However, in most cases following facial bone surgery, sagging typically affects both the midface and lower face, which limits the effectiveness of this method. Moreover, these techniques focus more on repositioning existing tissue rather than removing the excess, which can make the results less impactful.
Therefore, to effectively address sagging in both the midface and lower face, a comprehensive facelift procedure is necessary. Representative techniques include the High SMAS facelift, Extended SMAS facelift, and the facelift with the FAME technique. I presented on the anatomical basis and surgical details of each of these methods, as well as the treatment outcomes achieved using a combined approach: Ryu Minhee Facelift (High SMAS facelift with finger-assisted facial spaces dissection).
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https://rnwoodplasticsurgery.blogspot.com/2015/02/dr-ryus-facelift-technique-sci-2015.html |
Initially, this procedure was primarily used to treat sagging caused by aging. However, its application has since expanded to younger patients. This is because most individuals undergoing facial contouring or orthognathic surgery are in their 20s to 30s—and many of them seek treatment for sagging cheeks and jawline laxity that often follow such procedures.
The greatest advantage of my technique is its effectiveness in improving not only the lower face but also the midface. By integrating the advantages of the Extended SMAS, High SMAS, and FAME techniques—which all emphasize midface lifting—this approach allows for especially powerful results in the midface area.
This makes it particularly effective in correcting the prominent cheek sagging that often follows facial bone surgeries, which was the central focus of my recent presentation. Among all facial regions, the midface has the most complex anatomy and is one of the most challenging areas to achieve satisfactory results. That is why significant research has been devoted to this area and will continue to be an important focus moving forward.
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| https://rnwoodplasticsurgery.blogspot.com/2017/03/asps-aesthetica-2017-symposium-new.html |
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| https://rnwoodplasticsurgery.blogspot.com/2017/06/prs-global-open-sci-2017.html |
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| https://rnwoodplasticsurgery.blogspot.com/2016/09/plastic-surgery-meeting-asps-los.html |
To safely perform facelift surgery after facial bone procedures, several important considerations must be taken into account. First, careful attention must be paid to the anatomical changes caused by the previous surgery. Altered bone positioning, tissue adhesions, and scar formation are commonly observed, which can complicate the surgical field.
Another factor is the relative difficulty of the procedure. In younger patients, the skin, SMAS layer, retaining ligaments, and other soft tissues tend to be firmer and more resilient, making dissection more technically demanding. Therefore, to ensure both safety and satisfactory outcomes, the surgeon must possess a deep understanding of anatomy, extensive surgical experience, and the ability to anticipate a wide range of variables.
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| https://rnwoodplasticsurgery.blogspot.com/2025/07/invited-faculty-participated-lecture.html |
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| https://rnwoodplasticsurgery.blogspot.com/2017/05/invited-faculty-in-mafac-san-diego-2017.html |
The Maliniac Lecture is a memorial lecture named after Dr. Jacques W. Maliniac, the founder of the American Society of Plastic Surgeons (ASPS). Held once a year during the ASPS annual scientific meeting, it honors individuals who have made significant contributions to the history and advancement of plastic surgery.
This year, Dr. Fernando Molina was invited to deliver the lecture, titled "Maliniac Lecture: Curiosity and Ingenuity—Powerful Forces in Reconstructive Surgery Evolution." In his talk, he introduced legendary pioneers who have left a profound mark on the field of reconstructive surgery. These included Dr. Paul Tessier of France, Prof. Yang, the innovator of the radial forearm flap (also known as the Chinese flap), and Dr. Fernando Ortiz Monasterio of Mexico.
While the United States currently leads the field of plastic surgery, the lecture served as a reminder that key figures from Europe, Asia, and Latin America have also made invaluable contributions to the development of this discipline.
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While Western patients are often interested in augmenting underdeveloped cheekbones or jawlines, East Asian patients tend to focus on reducing prominent cheekbones and square jaws. The cheek sagging that frequently follows such bone-reduction surgeries is a phenomenon unique to East Asians, rarely seen in Western patients. Additionally, most of these patients are relatively young. These characteristics seemed to pique the curiosity of the audience.
This highlights how facelift surgery is expanding beyond its traditional role of anti-aging to include corrective applications after other types of facial surgery. Although my presentation may have had its limitations, I was honored to share my work at the American Society of Plastic Surgeons (ASPS) Annual Meeting, the most prestigious conference in the field.
I’m reminded of the importance of continued effort—to deliver safe, satisfying outcomes and to contribute meaningfully to the advancement of this evolving area of plastic surgery.
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A closer examination of the frequency of facelift procedures following facial bone contouring surgery is also necessary. However, there is currently no dedicated research on this topic. According to various publications, the incidence of soft tissue sagging after such surgeries ranges from 3–5%. The more prominent the malar and mandibular angles are preoperatively, and the greater the extent of reduction and dissection, the higher the likelihood and severity of sagging. Additionally, the surgeon’s specific technique likely plays a role in these outcomes.
In our study, many patients underwent not only malar reduction, but also mandibular angle reduction, two-jaw surgery, and genioplasty. These procedures were commonly performed using an intraoral approach, which we believe contributed to the degree of tissue sagging and ultimately served as the surgical indication for facelifting.
When considering the three most prestigious conferences in plastic surgery, the annual meetings hosted by the American Society of Plastic Surgeons (ASPS), the American Society for Aesthetic Plastic Surgery (ASAPS), and the International Society of Aesthetic Plastic Surgery (ISAPS) stand out. Among these, the ASPS conference is held every fall. This year, it is scheduled to take place from October 6 to 10, 2017, in Orlando, Florida.
I am honored that my paper was accepted for oral presentation at this event. Titled “Facelift Technique for the Management of Soft Tissue Drooping after Facial Bone Contouring Surgery in Asian Patients,” my presentation focuses on improving soft tissue sagging following facial bone surgeries such as malar reduction and mandibular angle reduction using the Ryu Minhee SMAS Technique.
East Asians tend to have relatively wide faces, which has driven the development of surgeries aimed at contouring this feature. The most common procedures are malar (cheekbone) reduction and mandibular angle reduction. However, soft tissue sagging often occurs after these surgeries. As the facial bones are reduced, the overlying soft tissues tend to loosen proportionally, resulting in sagging cheeks and marionette lines.
To address this, facelift surgery is needed, and there are many different techniques available. I have focused on combining approaches that are especially effective for the midface—namely the High SMAS, Extended SMAS, and FAME techniques—to develop a surgical method that particularly improves cheek and marionette line sagging after facial bone contouring. I am scheduled to present this work at the upcoming American Society of Plastic Surgeons (ASPS) Annual Meeting.
Such surgeries are generally unnecessary and unfamiliar to Western patients. As a result, facial bone reduction procedures have primarily been performed on East Asians, which meant they received limited attention until recently. However, with the rapid rise of cosmetic surgery in China, I expect demand for these procedures to increase significantly in the near future. Most patients seeking these surgeries are young women, suggesting the emergence of a new market.
Among the various facelift techniques available, my method—which is particularly effective in improving both the midface and lower face—offers differentiated benefits compared to others. I believe this is why my paper was accepted at a prestigious American conference. By consistently promoting these efforts, I am confident that we can lead and shape this growing market.
Following the presentation, I plan to publish the study in a U.S.-based scientific journal (SCI). This topic may be unfamiliar to Western audiences because they typically have smaller and narrower faces, making procedures like malar or mandibular angle reduction unnecessary. However, many patients in Asia—particularly in Korea and China—suffer from soft tissue sagging after facial bone surgeries, and this presentation will help raise awareness about effective ways to address these issues.
I also look forward to engaging in discussions with leading experts from around the world to explore whether even better techniques can be developed.
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Dr. Minhee Ryu, M.D.
RNWOOD Plastic Surgery
Seoul, South Korea
(Source: https://blog.naver.com/rejuvemaster/221122520014 )
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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