Anatomical evidence regarding the existence of sustentaculum facies.

The face, seen as a unitary region is subject to the gravitational force. Since it is the main relational and socialization region of each individual, it presents unique ways of suspension. The elevation system of the face is complex, and it includes four different elements: the continuity with the epicranial fascia, the adhesion of superficial structures to the peri- and inter-orbital mimic muscles, ligaments adhesions and fixing ligaments of the superficial layers to the zygomatic process, and also to the facial fat pad. Each of these four elements were evaluated on 12 cephalic extremities, dissected in detail, layer by layer, and the images were captured with an informatics system connected to an operating microscope. The purchased mesoscopic images revealed the presence of a superficial musculo-aponeurotic system (SMAS) through which the anti-gravity suspension of the superficial facial structures become possible. This system acts against face aging and all four elevation structures form what the so-called sustentaculum facies. The participation of each of the four anatomic components and their approach in the facial rejuvenation surgeries are here in discussion.