Virtually Scarless Midface Rejuvenation

SDCC 

Younger patients in their thirties and early forties are presenting to the plastic surgeon because they want to reduce the early tear-trough deformity and lighten early naso-labial grooves that make them looked tired. This results from the medio-inferior descent of malar fat and Sub Orbicularis Occuli Fat. There is a loss of the "ogee" curve of the face and in order to restore a youthful appearance to the face the surgeon has to reposition these two essential "padding" structures. However, this is not achieved even with a traditional full surgical face lift which tends to address the lower face and hardly deals with the mid-face. Improvement of the sagging mid-face can only be achieved by re-positioning of the malar and SOOF pads. This paper describes a simple scar-less technique to do that
By using 4-6 stab-incisions in a special pattern behind the temporal and side-burn hairline a number of 4/0 non-absorbable (polypropylene) suspensory suture-loops, are positioned in the malar fat pads with a spinal needle and anchored, under traction, on the superficial temporalis fascia. One can easily lift the malar and sub-orbicularis oculi fat to create a youthful lower eyelid and ogee curve to rejuvenate the face. Traction on the malar fat pads will also lighten the jowls and improve the corner of the mouth.
The operation is performed with simple instruments. It is easy, safe and suitable for younger patients (as well as part of the full face-lift) and there is a rapid recovery. It is also a valuable tool to "restore" a classical face-lift after a few years.
The disadvantages are that accurate positioning of the loops is essential. This can be a rather uncomfortable operation for about 50% cases in the initial 24 hours.

This report will cover over 500 cases done over the past 20 years.

Aesthetic

PSTM 2024