30 Essential Plastic Surgery Terms

SMAS · Superficial Musculoaponeurotic System

Superficial Musculoaponeurotic System

A continuous sheet of fascia just beneath the skin that wraps and connects the muscles of facial expression. First described by Mitz and Peyronie in 1976, it is the layer a facelift actually lifts — and how it is handled goes a long way toward determining the result.

AVA's Perspective: In our Dual-Deep Plane lift, we don't pull the SMAS in isolation. We release it together with the deeper tissue beneath and reposition both as one unit — so closing tension is carried by the SMAS layer, not the skin at the incision line, keeping scar burden to a minimum (individual results vary).

Dual-Plane · Deep Plane Facelift

Dual-plane / Deep-plane lift

A lifting technique that separates and repositions the skin and the SMAS with its underlying deep tissue along two distinct dissection planes. After Hamra introduced the deep-plane concept in the 1990s, Jacono AA's 2014 Aesthetic Surgery Journal study put the long-term durability of deep-plane lifts at 5–15 years (individual results vary).

AVA's Perspective: AVA Plastic Surgery takes this a step further with our Dual-Deep Plane approach, built around natural repositioning of the mid-cheek. Full details are on our facelift page.

Reference: Jacono AA. Aesthet Surg J, 2014.

Retaining Ligament

Connective tissue bundles anchoring skin to periosteum and deep fascia

The zygomatic, masseteric, and mandibular ligaments — dense bands of connective tissue that anchor the skin firmly to the periosteum and deep fascia. Mendelson BC's 2008 paper in Plastic and Reconstructive Surgery showed that these ligaments define the anatomic boundaries of the mid-cheek and malar mound.

AVA's Perspective: If these ligaments aren't adequately released during a lift, the tissue can't travel upward as intended — it gets pulled only partway, producing the unnatural, wind-swept look surgeons call 'lateral sweep.' Dr. Kim Seungsoo's rule is to release them precisely, along safe dissection planes.

Reference: Mendelson BC. Plast Reconstr Surg, 2008.

Midcheek

The mid-facial region from below the zygomatic arch to the nasolabial and lateral nasal areas

Mendelson BC's 2008 PRS paper mapped this region's anatomic boundaries and aging patterns in detail. Because midcheek descent produces nasolabial folds, tear troughs, and malar mounds all at once, a deep-plane lift that treats the region as a single unit is particularly effective.

AVA's Perspective: Rather than chasing one or two trouble spots piecemeal, we read the midcheek as a single unit and reposition it as a whole — naturally.

Nasolabial Fold

Deep crease extending from the nose to the corner of the mouth

Deepens through a combination of midcheek descent, sagging of the malar fat pad, and skeletal change. It can be softened with filler or corrected at the source by lifting the descended tissue back into place — the right choice depends on the fold's depth and cause. Mendelson 2008 analyzed its anatomic determinants in detail.

AVA's Perspective: Once the fold runs deeper than 8mm and comes with true tissue descent, filler alone has its limits; we recommend a lift to address the underlying cause.

Jowl

Drooping skin and fat along the lateral jawline

Forms where the mandibular ligament tethers the skin while the tissue just in front of it descends. With age, the deep fat compartments beneath the SMAS descend as well — which is why a jowl is not loose skin but a descent of the entire deep tissue layer. The result: a once-crisp jawline blurs into a bulldog-like contour.

AVA's Perspective: Pulling on skin cannot undo the descent of deep fat. In a lift, we release the mandibular ligament and carry the SMAS and deep fat upward and back together, working toward a clean jawline (see Dual-Deep Plane).

Platysma

Thin, broad superficial muscle covering the anterior neck

The neck's continuation of the SMAS, and treated together with it in facelift surgery. With age, the paired platysma muscles drift apart at the midline, creating the vertical cords known as 'platysmal bands.' Left unaddressed, they can make the neckline look unfinished even after a facelift.

AVA's Perspective: We don't treat a facelift as a face-only operation; the platysma and neck are assessed as one continuous unit with the face.

Tear Trough

Shadowed depression extending from below the eye to the cheek

Forms where the orbital retaining ligament tethers the skin while the fat above it deflates and descends, casting a shadow. One cause of dark circles — and one that should be assessed together with pigmentation and visible underlying vessels.

AVA's Perspective: The options run from filler to autologous fat grafting to release-and-reposition surgery — the right one depends on the trough's depth, your skin thickness, and your individual anatomy.

Autologous Costal Cartilage

Patient's own 6th–7th rib cartilage harvested for nasal reconstruction

A go-to alternative when implant-only rhinoplasty runs into complications — protrusion, contracture, exposure. Because it is the patient's own tissue, the risk of immune rejection is lower, and it offers enough volume for multiple revisions and complex reconstructions. Gunter JP's Dallas Rhinoplasty sets out the standard anatomic principles for its use.

AVA's Perspective: Rib cartilage can warp, which makes carving and fixation technique decisive. Dr. Kim Seungsoo discusses warping risk with every patient in advance and uses carving and fixation methods designed to reduce it (individual results vary). Full details are on our rhinoplasty page.

Stranc Classification

Classification of nasal bone fractures by fracture line direction and septal involvement

Grades traumatic nasal bone fractures as Plane I, II, or III — a framework that guides both the direction of reduction and how long the splint stays on.

AVA's Perspective: A paper co-authored by Dr. Kim Seungsoo (Park KS, Kim SS, Lee WS — Archives of Craniofacial Surgery, 2017, 18(2):97-104) presents a fracture reduction algorithm built on this classification. We draw on it when assessing the nasal bones of revision patients with a history of trauma.

Spreader Graft

Elongated cartilage reinforcement graft placed alongside the septum

Widens the internal nasal valve to keep the airway open and guards the middle vault against collapse. Used for short noses, deviated noses, and noses that have collapsed around a previous implant. A standard technique in Gunter's Dallas Rhinoplasty.

AVA's Perspective: In revision cases where the septal cartilage has already been spent, we carve autologous rib cartilage into spreader grafts instead.

Septum

Cartilage + bone structure dividing the nose left and right

A key cartilage source in autologous rhinoplasty. Each revision draws down the septal reserve, however, and once it runs low the operation transitions to rib cartilage. A deviated septum can also affect breathing — worth considering for correction at the same time as rhinoplasty.

Columella

Short pillar separating the two nostrils

Part of the scaffolding that holds the nose up. In correcting a short or upturned nose, reinforcing it with a columellar strut graft can help bring the tip down.

Tip Plasty

Nasal tip surgery controlling tip shape, angle, and projection

Shapes the nasal tip by adjusting the form and position of the lower lateral cartilages. Gunter's Dallas Rhinoplasty standardized how tip deformities are analyzed and corrected.

AVA's Perspective: To move past the known limits of implant-only tip work — show-through, protrusion — we recommend rebuilding the tip with the patient's own cartilage.

Hump

Dorsal convexity where nasal bridge profile curves upward

The result of excess bone and cartilage along the bridge. The standard approach is resection followed by lateral osteotomy to narrow the dorsum; taking too much invites an inverted-V deformity, which a spreader graft helps prevent.

Capsular Contracture

Thickening and contraction of fibrous capsule around implant

A complication that develops over time around implants such as silicone or Gore-Tex. The Baker classification grades it I–IV; grades III–IV involve visible deformity and pain, and are an indication for revision.

AVA's Perspective: Converting to the patient's own tissue (such as autologous rib cartilage) is one way out. Among nasal implant complications, capsular contracture is one of the more frequently reported.

Levator · Levator Palpebrae Superioris

Muscle that lifts the eyelid

The muscle that opens the eye, attaching to the tarsal plate via the levator aponeurosis. When the muscle weakens — or its aponeurotic attachment stretches loose — the result is ptosis.

AVA's Perspective: Ptosis correction at AVA Plastic Surgery shortens and re-anchors the levator aponeurosis, aiming to open up both the visual field and the look of the eyes (individual results vary).

Ptosis

Eyelid droop covering the pupil and narrowing visual field

Caused by a weak levator muscle or a lax aponeurosis. Because it can encroach on vision, correcting it is functional treatment — not mere cosmetics. Looking straight into a mirror, if your upper lid drapes 3mm or more over the iris, ptosis is worth suspecting.

AVA's Perspective: If your forehead is constantly working, or your frown lines run deep, you may be propping your eyes open with the frontalis muscle without realizing it — something we evaluate as part of the same exam.

Eyelid Crease · Supratarsal Crease

Skin fold formed above the tarsal plate

Occurs naturally in about 50% of Asians; where it is absent, surgery can create it. The technique — buried suture, partial incision, or full incision — is matched to the lid's thickness, muscle strength, and how much surplus skin is present.

AVA's Perspective: Our natural-adhesion design 'repositions along the grain' of the lid, keeping visible scar burden low. Full details are on our eyelid surgery page.

Tarsal Plate

Firm connective tissue plate inside the eyelid

The insertion point of the levator aponeurosis, and a key structure in both ptosis correction and crease fixation. Reading its thickness and position accurately during surgery is what keeps the crease line stable.

Levator Aponeurosis

Thin, broad tendinous sheet extending from levator to tarsal plate

The structure shortened and re-anchored in ptosis correction. How much is shortened — and where it is fixed — determines how far the visual field opens and how natural the crease looks.

Buccal Fat

Deep fat pad occupying space from below the zygomatic arch to lateral oral commissure

Removing it slims the cheeks — but as the face naturally loses volume with age, that early hollowing can turn into regret in midlife. Candidacy deserves careful assessment.

AVA's Perspective: We lay out both sides — the slimming you would enjoy now and the risk of looking gaunt in midlife — so the decision is made with eyes open.

Dermis Fat Graft

Graft of fat tissue with attached dermis for depressed area augmentation

Resorbs less than fat alone, making it the more stable graft — though the donor-site scar has to be weighed. Used to build up hollow areas after a lift and to reconstruct defects after trauma.

HIFU · High-Intensity Focused Ultrasound (Ultherapy)

Ultrasound energy reaching deep skin layers to stimulate collagen

Not a substitute for a surgical lift — a different tool for different indications. It delivers focused thermal energy down to the depth of the SMAS to stimulate collagen renewal, but it cannot perform the retaining ligament release or tissue repositioning that a deep-plane lift addresses.

AVA's Perspective: Genuinely useful as non-invasive care for early-to-moderate laxity — but where deep tissue has descended, we don't recommend asking HIFU alone to do a lift's job.

Fractional Laser

Laser delivery method targeting skin in micro-dot pattern

Because the untreated skin between the dots drives healing, recovery is quicker and downtime shorter. Used to improve scars, pores, and overall texture. Available in CO2, Er:YAG, and non-ablative forms.

Botulinum Toxin (Botox)

Blocks acetylcholine at neuromuscular junction to temporarily weaken muscle contraction

Used for frown lines, forehead lines, and crow's feet, as well as masseter slimming and excessive sweating. It takes effect in 2–5 days and lasts 3–6 months (individual results vary). Temporary asymmetry or weakness of expression is possible — we explain this before treatment.

Hyaluronic Acid Filler

Crosslinked polysaccharide injectable naturally present in skin

A volumizing treatment. Viscosity, longevity, and suitable treatment areas differ from product to product, with results typically lasting 6–12 months (varies by product, area, and individual). We review the risks — bruising, nodules, and rare vascular complications — before treatment.

Zygomaticomaxillary Complex (ZMC)

Key facial skeletal structure formed by zygomatic and maxillary bones

A fracture here can affect facial contour, bite, and even vision.

AVA's Perspective: A paper co-authored by Dr. Kim Seungsoo (Ji SY, Kim SS, Kim MH — Archives of Craniofacial Surgery, 2016, 17(4):206-210) analyzed surgical reduction methods for ZMC fractures.

Single-Surgeon System

Operational model where one physician performs consultation, surgery, and follow-up

Every operation is performed start to finish by Dr. Kim Seungsoo himself, and the next patient is never scheduled to begin before the current surgery is complete. The point is continuity: one record, one surgeon, one clear line of accountability.

AVA's Perspective: AVA runs as Dr. Kim Seungsoo's sole-practitioner system, under a strict no-delegation policy — zero ghost surgery.

Stay Suture

Non-absorbable deep-layer suture fixing tissue position before skin closure

Shifts the tension the skin would otherwise bear into the deep layers (SMAS and below), so the skin at the lateral incision line can be closed under minimal tension. A cornerstone of our philosophy of minimizing scar burden.