Explore lower blepharoplasty combined with tarsal ligament reinforcement, with commentary on the surgical technique and the role of lower eyelid support. Subscribe to our Premium plan for weekly aesthetic surgery videos with expert commentary.

The preoperative marking of the Round-Block SMAS-Pexy is designed according to the different vectors required to reposition the facial and cervical tissues. In the midface, the main vector is directed superiorly and slightly superolaterally, restoring the position of the descended soft tissues. The SMAS is secured using a round-block purse-string suture, typically performed with 3-0 Monocryl or 3-0 PDS, creating a circumferential suspension that redistributes tension throughout the treated area. From the tragal region, the traction vector becomes predominantly vertical, providing support to the lower face and helping redefine the mandibular contour. In the cervical region, the vector changes toward a more posterior direction, allowing redraping and repositioning of the tissues of the neck while avoiding excessive tension on the skin. Therefore, the technique combines different vectors according to the anatomical region: Midface → round traction Tragal and lower-face region → posterior traction Cervical region → posterior traction The objective is to reposition the deeper facial structures through SMAS suspension rather than relying primarily on skin tension, allowing the skin to follow the newly repositioned deep tissues and helping achieve a more natural facial contour.

This space was created to connect plastic surgeons from around the world who share the same commitment to education, surgical excellence, collaboration, and continuous improvement. Here, we will discuss real cases, exchange experiences, share selected surgical content, announce webinars and events, and build an international network of colleagues who can learn from one another. To get started, introduce yourself in the comments with: * Your name and country * Your specialty * Your main area of interest * One surgical topic you would like to discuss in the community Our goal is simple: *learn together, share knowledge, connect globally, and grow as surgeons. Welcome to the community. Prof. Dr. Marcelo Policarpo de Souza Assis Founder & Host — Aesthetic Global Training Learn. Share. Connect. Grow.