Understanding Facial Retaining Ligaments

The Hidden Support System Behind Facial Ageing.

Earlier this year, I travelled to Korea to deepen my study of facial anatomy, with a particular focus on the retaining ligaments.

Learning how these structures relate to the skin, fat, fascia, muscles and bone changed the way I understand the quiet architecture beneath the surface and the way I approach hands-on work.

In this guide, I explain what retaining ligaments do, how they relate to facial ageing and how specialised manual therapy such as ReFace Therapy works with them.

How Ligaments Support the Face

Facial retaining ligaments are strong, fibrous connective-tissue structures that tether the superficial facial tissues to deeper fascia and, in some areas, bone.

Some arise from bone, while others connect deeper fascia to the SMAS. Together with their smaller fibrous extensions, they help stabilise the facial tissues and form boundaries between facial spaces and fat compartments.

Rather than holding the whole face together, the ligaments act as fixed attachment points within its layered structure. Their position helps support facial contour and explains why certain folds and grooves appear in predictable areas.

How the Face Changes Over Time

Facial ageing is not caused by ligament changes alone. It occurs across every layer of the face, including the skin, fat, muscles, fascia, SMAS, bone and ligamentous structures.

Research also suggests that not every retaining ligament simply becomes loose. Some deeper ligaments remain strong, while smaller superficial fibres and the surrounding tissues may change over time.

Together, these changes may contribute to:

• Softer definition through the cheeks and jawline.

• Deepening folds around the nose and mouth.

• Fullness, hollowing or shadowing beneath the eyes.

• Changes around the brow and upper face.

These changes usually happen gradually and differ from person to person. Understanding the ligament attachment points helps us see which areas are more firmly anchored, which areas have greater movement and why different parts of the face change in different ways.

Circulation, Lymph and the Neck Connection

Retaining ligaments are not drainage channels. However, they sit within the same layered anatomy as the facial arteries, veins, lymphatics and nerves. Some vessels and nerve branches travel close to or between certain ligaments, which is one reason a precise understanding of facial anatomy is important.

Facial lymph and venous blood drain through networks that continue towards the neck. This is why I consider the face, jawline and neck together during hands-on therapy.

Gentle work may help ease muscular tension and encourage fluid movement, helping some people feel less puffy and more comfortable. This is separate from the structural role of the retaining ligaments, but both can influence how the face looks and feels.

The Deeper Layers and the SMAS (Superficial Musculoaponeurotic System)

Beneath the skin and superficial fat lies the SMAS, or superficial musculoaponeurotic system. It is a fibromuscular layer connected with the muscles of facial expression and the skin.

The retaining ligaments help anchor the SMAS to deeper, more fixed structures. Together, these layers transmit facial movement and help organise and support the facial soft tissues.

Age-related changes do not happen within one layer alone. Understanding how the SMAS, ligaments, muscles, fascia, fat compartments and bone relate to one another allows for a more precise and considered approach than focusing only on the surface of the skin.

Practical Takeaway

Breathing, movement and posture may support general wellbeing, circulation and muscular comfort, but they do not restore the retaining ligaments.

There are different ways to approach changes involving the retaining ligaments. One way to help restore and lift them is through specialised manual therapy such as ReFace Therapy.

This is not a general facial massage. It requires precise hands-on techniques and a detailed understanding of ligament anatomy. If you are interested in this approach, seek a practitioner trained specifically in facial retaining ligament manual therapy.

Every face responds differently, so the changes seen and the number of sessions needed will vary from person to person.