Think of facial ligaments as dense, fibrous structural anchors. They connect the deeper layers of your face—your muscles and fat—directly to the underlying bony skeleton.
In your 20s, these anchors hold everything firmly in place. But as time goes on and gravity does its work, the facial tissue begins to slide downward. Here’s the paradox: as the tissue sags, those same ligaments stay firmly attached, creating deep folds, jowls, and tethered spots across your lower face.
The Carpet & The Nails: Dr. Gadaleta’s Analogy
Plastic surgeon Dr. Gadaleta uses a brilliant analogy to explain how true structural lifting works: Imagine a thick carpet securely nailed to a wooden floor. If you try to move that carpet by pulling on the edges, it won't budge. If you pull harder, you’ll just stretch out the fabric, distort the pattern, or tear the edges. To move the carpet smoothly across the room without damaging it, you first have to go underneath and pull out the nails.
In facial surgery: The Muscle & Deep Tissue is the carpet. The Ligaments are the nails. The Skin is just the decorative fabric sitting on top. An extended release deep plane facelift goes beneath the muscle layer to completely pull those "nails" out.
Once those tethers are freed, your surgeon can gently reposition your deep facial tissue back to where it belonged ten years ago—without pulling on your skin at all.
Why Tension Is the Enemy
Tension is what gives facelifts a bad reputation. When a surgeon doesn't release those deep ligament tethers, they are forced to pull hard on the outer layers to force a change.
The Outcome on Your Face - High Tension (Pulling against unreleased ligaments)
Wide, stretched-out scars, flattened cheeks, distorted earlobes, and a short-lived result that drops in 1–2 years.
Zero Tension (Wide ligament release) (NOT every doctor is doing it)
Crisp, invisible incision lines, restored youthful cheek contours, and a natural look that lasts a decade or more.
Questions From the Patient Room
Here are two questions my own clients recently asked about this technique:
Q: What does "wide ligament release" actually mean?
A: A standard facelift might only release the ligaments near your ears or upper cheekbones. A wide release means dissecting deep beneath the muscle layer all the way forward to the corners of your mouth (marionette lines) and the sides of your nose (nasolabial folds). Releasing these forward tethers is what allows the entire midface to float back up naturally.
Q: Can a deep plane facelift still have tension if done incorrectly?
A: Absolutely. If a surgeon attempts a "deep plane" approach but stops short and fails to release those front ligaments, the midface remains stuck. To compensate, they end up pulling harder on the back edges or the skin itself—reintroducing the exact tension we want to avoid.
The Regan Method
The Regan Method, The Regan Surgical Collective, and The Regan House are about bringing truth to an industry that doesn't currently want it to exist. But we are changing that, one real conversation at a time. Visit the website and see what patients and doctors are discovering by joining Mary.