Three-Dimensional Facial Contouring: Utilizing Upper-Midface Suspension Technology and Alloplastic Augmentation

ABSTRACT

Facial aesthetic surgery procedures have evolved to the highest level possible, the three-dimensional restructuring of facial form. Repositioning of the deep soft tissue planes from the neck to the zygoma as well as subperiosteal, upper, and midface elevation have become commonplace. Alloplastic implant contouring is not only a useful adjunct, but it should be a fundamental tool used with the variety of new facial aesthetic techniques. It is now possible for the aesthetic surgeon to variously restore, rejuvenate, or enhance facial forms of either hereditary or aging origins. Infinite variations in facial contour are now possible. By using alloplastic techniques based on concepts of zonal anatomy and aesthetic deficiency typing, the bony and soft tissue contours of the face can be created or modified with a minimum of complications. The use of alloplastic implants on the “fourth skeletal plane” represents an optimum, significant, three-dimensional manipulation of both the soft tissues of the face and the skeletal anatomic elements of mass and volume.

KEYWORDS

Alloplastic - facial contouring - implants - upper midface suspension

REFERENCES

• 1 Rees T D. Aesthetic Plastic Surgery. Philadelphia, PA: WB Saunders: 1980
• 2 Gonzalez-Ulloa M. Planning for the integral correction of the human profile.  J Int Coll Surg . 1961;  36 3
• 3 Hinderer U T. Profileplasty.  Int Micr J Aesth Plast Surg . 1971;  1(1) Insert
• 4 Terino E O. Unique manidublar implants, including lateral and posterior angle implants.  Facial Plast Surg Clin North Am . 1994;  2 311-328
• 5 Terino E O. Implants for male aesthetic surgery.  Clin Plast Surg . 1991;  18(4) 731-749
• 6 Carpenter R. The Esthetic Basics of Greek Art. Bloomington, IN: Indiana University Press; 1959
• 7 Terino E O. Alloplastic facial contouring: surgery of the fourth plane.  Aesthet Plast Surg . 1992;  16 195-212
• 8 Terino E O. The Art of Alloplastic Facial Contouring. St. Louis, MO: Mosby; 2000
• 9 Peterson R. The role of the platysma muscle in cervical lifts. In: Symposium on Surgery of the Aging Face St. Louis, MO: CV Mosby 1978: 115
• 10 Connell B F. Cervical lift: surgical correction of fat contour problems combined with full width platysma muscle flap.  Aesthet Plast Surg . 1978;  1 355
• 11 Guerrero Santos J. Neck lift. Simplified surgical technique, refinements, and clinical classification.  Clin Plast Surg . 1983;  10(3) 338-347
• 12 Guerrero-Santos J. The role of the platysma muscle in rhytidoplasty.  Clin Plast Surg . 1978;  5 29
• 13 Hamra, S T. The zygorbicular dissection in composite rhytidectomy: an ideal midface plane.  Plast Reconstr Surg . 1998;  102(5) 1646-1657
• 14 Tessier P. The definitive plastic surgical treatment of the severe facial deformities of craniofacial dysostosis. Crouzon's and Apert's diseases.  Plast Reconstr Surg . 1971;  48 419
• 15 Ramirez O M. The subperiosteal rhytidectomy: the third-generation face lift.  Ann Plast Surg . 1992;  28 218
• 16 Terino E O. Lateral canthopexy: a simple two suture method, presented at the annual meeting of the American Society for Aesthetic Plastic Surgery, Los Angeles, CA; 1987. 
• 17 Matarasso A, Terino E O. Forehead-brow rhtytidoplasty: reassessing the goals.  Plast Reconstr Surg . 1994;  93(7) 1378-1391
• 18 Namazie A R, Keller G S. Current practices in endoscopic brow and temporal lifting.  Facial Plast Surg Clin North Am . 2001;  9(3) 439-451
• 19 Hester Jr R T. Evolution of lower lid support following lower lid/midface rejuvenation: the pretarsal orbicularis lateral canthopexy.  Clin Plast Surg . 2001;  28(4) 639-662

1 ImplanTech Corporation, Ventura, CA