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Muscles for Facial Expressions

Muscles for Facial Expressions

The craniofacial muscles are a collection of approximately 20 thin skeletal muscles situated beneath the skin of the face and scalp. These muscles, primarily responsible for the vast array of human facial expressions, originate from the bones or fibrous structures of the skull and extend outwards to connect with the skin. While most skeletal muscles in the body are enveloped in thick fascia, facial muscles generally have a more delicate fascial covering, with the buccinator muscle being a...

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How Does Injecting Filler Into Facial Ligaments Result in Facial Lifting?

Gi-Woong Hong¹, Arthur Swift², Mariana César Corrêa³

¹Samskin Plastic Surgery Clinic, Seoul, Korea.

The Journal of Craniofacial Surgery

|January 14, 2026

Summary

This summary is machine-generated.

Dermal fillers enhance facial contour by reinforcing natural facial ligaments. Targeted injections beneath the SMAS layer provide mechanical lift, improving skin suspension and rejuvenation.

Keywords:

Biomechanics SMAS facial lifting facial ligaments filler injection hyaluronic acid

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Area of Science:

Aesthetic medicine
Facial anatomy
Biomechanical engineering

Background:

Dermal filler injections are used for facial volume restoration and contour improvement.
The precise mechanism of the lifting effect of dermal fillers is not fully understood.
This study investigates the role of facial ligamentous structures in filler-induced facial lifting.

Purpose of the Study:

To explore the mechanism of facial lifting by dermal fillers.
To investigate the contribution of facial ligamentous structures to mechanical support and contour elevation.
To correlate anatomical, ultrasonographic, and biomechanical findings with clinical observations.

Main Methods:

Cadaveric dissection and high-frequency ultrasonography were used to examine major facial retaining ligaments.
Morphology, orientation, and density of zygomatic, mandibular, and platysmal-auricular ligaments were analyzed.
Sub-superficial musculoaponeurotic system (SMAS) filler deposition effects on fibrous anchoring structures were correlated with clinical facial dynamics.

Main Results:

Facial retaining ligaments are collagen- and proteoglycan-rich structures providing tensile resistance.
Age-related weakening of these ligaments diminishes facial suspension capacity.
Sub-SMAS filler injection enhances local fibrous density and SMAS tension, leading to mechanical lift transmitted through ligamentous attachments.
Targeted reinforcement of dense ligamentous zones resulted in efficient contour elevation with minimal filler volume.

Conclusions:

The lifting effect of dermal fillers is a combination of volumetric restoration and biomechanical reinforcement of fibrous anchoring structures.
Understanding the regional variations and mechanical properties of facial ligaments allows for anatomy-based, low-volume rejuvenation strategies.
Further clinical and quantitative biomechanical studies are needed to validate these findings under physiological conditions.