Overview
Parts of the facial skin are tied down to bone and deeper tissue by ligaments. The author describes four of these retaining ligaments of the cheek, where they attach, and how they affect facelift dissection. The abstract reports no patient numbers.
Findings
- Zygomatic ligaments (McGregor's patch): anchor cheek skin to the lower border of the cheekbone, just behind the origin of the zygomaticus minor muscle.
- Mandibular ligaments: tether the skin to the front of the jawbone.
- Both of these ligaments block surgical moves that advance the skin.
- Both also hold the facial skin against gravity and mark the front border of the jowl.
- Platysma-auricular ligament: a thin fascial sheet from the upper back border of the platysma, closely attached to the skin around the ear; it guides the surgeon to the upper back border of the platysma.
- Anterior platysma-cutaneous ligaments: variable bands that anchor the SMAS and platysma to the skin; they can lead the surgeon into false planes in the skin.
- All four ligaments serve as reference points during facial dissection.
- The zygomatic and mandibular ligaments must be released if maximum upward movement of the facial skin is desired.
What it means for a patient
- The mandibular ligaments mark the front border of the jowl and hold the skin against gravity.
- To lift the cheek and jowl skin as far as possible, the surgeon has to release the ligaments that hold it down.
- Ask your surgeon how they handle these ligaments during your facelift.
- This is an anatomy description. It does not report facelift results or complications.
Why this paper matters
It described the retaining ligaments of the cheek as anchors, as guides for dissection, and as a limit on how far the skin can be lifted. Cited 343 times (NIH iCite, 2026-09-25).
Terms
- Retaining ligaments: strong fibrous bands that hold facial skin and soft tissue to bone or deeper layers.
- Zygoma: the cheekbone.
- Mandible: the lower jawbone.
- Jowl: the sagging tissue along the jawline in front of the ear and behind the chin.
- Platysma: the thin muscle over the front of the neck.
- SMAS: the layer of muscle and fibrous tissue under the facial skin and fat.
- Dermis: the deep layer of the skin.
- False plane: a wrong layer a surgeon can enter by mistake during dissection.