Deep Plane Facelifts, Recovery Myths & ECM Injections: Inside APS Korea 2026 with Dr. Roy Kim

In this episode, board-certified plastic surgeon Dr. Roy Kim shares his firsthand experience from APS Korea 2026 — the largest aesthetic plastic surgery conference in South Korea. Dr. Kim breaks down the two biggest trends dominating the conference: the evolution of the deep plane facelift and the growing conversation around ECM (extracellular matrix) injections as the next frontier in non-surgical facial rejuvenation.

He also debunks the hype around popular post-facelift recovery treatments — including hyperbaric oxygen, red light therapy, and lymphatic drainage — and shares what the evidence actually supports. Plus, he reveals how Korean beauty standards around jawline aesthetics differ from those in the West.

In this episode:

• What's really driving the deep plane facelift boom — and what's just marketing
• The truth about HBO, red light therapy & lymphatic drainage for post-facelift recovery
• What ECM (extracellular matrix) injections are and why Korea is leading the charge
• How Korean vs. Western beauty standards differ when it comes to jawlines
• Why ECM could be the next big thing in US aesthetics

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Transcript

Welcome And Seoul Travel Notes

SPEAKER_00 0:00

Welcome to the Beauty Standard with Dr. Roy Kim. Hey everyone, this is Dr. Roy Kim. I'm a board-certified plastic surgeon in San Francisco and Beverly Hills, and I wanted to talk about the trip I recently took to Seoul, South Korea, for the APS Korea meeting, which stands for Aesthetic Plastic Surgery. It is the largest cosmeticslash aesthetic plastic surgery conference in Korea, and I've been going for years now. I was honored to speak about the best aftercare treatments for deep plane facelift and facelift in general, and I'll talk about that in a moment. Of course, Seoul is one of my favorite cities. It's much bigger than New York. It has great food, great energy, and I just enjoy seeing my old friends and making new

Two Big Themes From APS Korea

SPEAKER_00 0:40

ones. This year, to me, there were two big themes dominated, and I wanted to share them

Deep Plane Facelift Reality Check

SPEAKER_00 0:45

with you. So, theme one was deep plane facelifts, which continues to grow. The keynote speaker, Doctor, is very famous for doing deep plane facelifts. He gave a great talk, and my talk was on exactly how or what to recommend to patients to get faster healing and a better aesthetic result after deep plane facelift. What's interesting is that this is a really hot, popular topic. The deep plane facelift really goes underneath the skin, underneath the SMAS, the SMAS, the layer that we use to support the face, and it goes more medial. In other words, sort of closer to the mouth area to get a bigger or better result. What's interesting is that in the US right now, deep plane facelifts are all the rage. There are marketing or branded versions of it. And patients do ask me about this all the time without understanding the actual anatomy. To be honest, most of the branded names are really marketing. The surgical technique itself is going underneath the SMAS more medially and with a little more skill. What surprised me a little about APS Korea is that the Korean approach is definitely deep plane, but definitely a lot less talk about technical differences because they feel that the technical differences are small. They are really not going that deep into the deep neck because, again, they're not really seeing a lot of the bulky necks that we see in the West. So that is my very strong opinion. The other thing is that they're semi-aggressive with the submandibular glands. In other words, the glands underneath the actual jawline or neckline. But again, I do think in Korea that this is of lesser concern because the patients are thinner and the submandibular glands really aren't quite as large. The other interesting thing aesthetically is that it's okay in Korea, especially in women, to have a softer jawline. It is definitely viewed as a little more masculine or aggressive to have a very sharp jawline. I do think that a very sharp jawline is much more prevalent in the West than definitely in America. In Korea, it is okay to have a softer jawline, to not have it as defined, is viewed as more

What Actually Helps Facelift Healing

SPEAKER_00 2:46

feminine. Next up is post-facelift recovery. So this is a very hot topic, and of course, I can talk a little about it because that's what I was asked to present. So patients in the US definitely asked me about HBO, hyperbaric oxygen, red light therapy, lymphatic massage, PRP injections, and on and on and on. They really want to know what speeds healing, and plastic surgeons wanted to know what's truly evidence-based. After doing a lot of deep dive research, my honest take is this most of the add-ons really lack strong supporting data. In other words, they may help, but there's nothing showing that they really truly help. Lymphatic drainage feels good. It does reduce the psychological weight of recovery, but the data showing it really changes outcomes is sort of thin. Red light therapy is great. However, even consistent use right after a facelift shows marginal or very small amounts of wound healing efficiency. The other problem is that protocols vary wildly, like which exact red light and how long to use it, and do you use it twice a day? The evidence is pretty thin. What's also interesting is that hyperbaric oxygen is very trendy right now, but specifically for facelift or any facial surgery, honestly, it's extrapolated from burn care, wound care, or other areas of the body that have worse blood flow. A better study needs to be done, but honestly, I think even if a better study was actually constructed, I don't think that it would be of much benefit for the facelift. The other thing, too, is that with deep plain facelift, the whole purpose of it is that we have less dissection. So as a surgeon, if we do less dissection, then there's less healing area underneath the skin and smash, which means that we really don't need HBO or hyperbaric oxygen. So I did tell the panelists and the audience the truth. And the good old things that we do, which includes giving it time, resting, high protein diet, elevating your head, icing is needed, no smoking, excellent blood pressure control. Those are the standards, and they do still the vast majority of the work.

ECM Injections And Skin Boosters

SPEAKER_00 4:47

Now, what's really hot in Korea is something that's non-surgical. ECM, extracellular matrix injections. I do think that this may change the injectable market over the next couple of years in the US, assuming that we can get it FDA approved. As a background, your skin and your facial tissues are built on a scaffolding. It's called the ECM, extracellular matrix. You can think of it as the framework holding up a building. It's made up of collagen, elastin, HA hyaluronic acid, and other proteins that give the skin its structure, bounce, and resilience. As we age, this matrix breaks down. Your skin gets thinner, it gets looser, it tends to sag more, it's less elastic. Most of what we treat honestly with skincare and lasers and injectables is matrix loss. In Korea, injectors, dermatologists, and now plastic surgeons have figured out how to use this matrix material, micronize it into fine particulate. In other words, chop it up into a very fine powder, load it up into syringes for direct injection into the face. So, yes, it's a dry powder and you have to stick in fluid to reconstitute it. They really have two options. The biggest one is a skin booster. So this is a less commonly known technique in the US and in the West. It's more common in Korea. Skin booster really is giving vitamins and minerals to the skin. It does not add volume. So if I can inject something that can improve skin quality, hydration, and texture, I'll do it. This is what ECM can do. What's interesting is that we have HA filler hyaluronic acid, HAA. We have that known as skin vive by allergan here in the United States. You can also add other chemicals, but ECM seems to really be the best current skin booster. Patients really describe it as having better glow, smoother fine lines, and healthier looking skin. ECM can be used as a volumizer. In other words, it can be used like traditional filler in the United States. You have to inject it deeper, it has to be a slightly different product, but it does provide structural support similar to filler. However, it has an added benefit of stimulating your own body to produce actual new collagen. It rebuilds your own matrix from the inside. Remember, this is human tissue. So some Korean injectors do use it at the same time, specifically a version that's meant for skin boosting, better quality skin, but no volume. And the volumizing one, the filler material, the ECM, that actually increases true collagen production. In the US, we actually have ECM products. In reconstruction or in aesthetic breast surgery, we have sheets of it. We can describe it as an internal bra, and it is used in breast reconstruction as well as cosmetic breast lift and occasionally cosmetic breast augmentation. We also have injectable fat. It's called Reneva R-E-N-U-V-A or A-L-L-O-C-L-A-E, where you can order this stuff. It comes to my office or in the operating room, and it's fat or fat-like or ECM-like product that I can use for your face or body. However, the really chopped up version, the micronized version, the stuff that comes in one or three CC syringes, the one that's really tiny, that's meant to improve facial skin quality and volume, that is not available in the US at all. Why the gap? I think it's because Korean moves faster on aesthetic products. And to be honest, we already have, as you can tell, similar products but in a different format, either sheet or much larger volume fat globules, as opposed to ECM, which is really tiny, they're very tiny particles. So in a lot of Korean dermatology offices, they'll stack ECM injections alongside their glass skin protocols on top of laser and skin booster. And this is part of routine maintenance. I do expect someday to see mechanized ECM injectables, but we'll see how quickly it can be done.

Takeaways Plus Listener Q And A Invite

SPEAKER_00 8:23

So in conclusion, deep plane facelifts are definitely getting more refined, not quite as aggressive, at least according to the talks that I saw from Korean plastic surgeons. In America, I still think there's a lot of confusion about what a deep plane facelift is, what it is in terms of marketing versus anatomy, and so on. In terms of post-facelift recovery treatments, my talk was well received, and I do think we need better evidence before throwing everything in the kitchen sink at a patient after surgery to get a faster or more efficient or more beautiful result. ECM, extracellular matrix, is very hot in Korea. I could totally understand why, and I do think it would be really game-changing in the U.S. if it actually becomes FDA approved and available. As always, thanks so much for joining me. And APS Korea was an amazing experience. I look forward to it next year. If you have any questions about facelift, necklift, or anything else, please listen to the other podcast episode where I talk about deep lane facelift. And hey, if you have any comments or questions, it could be a future podcast episode in the future. Thanks so much for listening. Thank you for listening to the Beauty Standard with Dr. Rick Kim. Make sure to follow for future topics and episodes.