RSS-Feed abonnieren
DOI: 10.1055/s-2003-40006
Midfacial Rejuvenation
Publikationsverlauf
Publikationsdatum:
24. Juni 2003 (online)
![](https://www.thieme-connect.de/media/fps/200302/lookinside/thumbnails/10.1055-s-2003-40006-1.jpg)
ABSTRACT
The midface is an important new area in facial rejuvenation. Rejuvenation of the midface is necessary to achieve harmonious rejuvenation of the face. The extent of “lift” to be achieved with midfacial elevation is very limited. Excessive elevation of midfacial tissues results in vertical shortening of the lower eyelid, round eye deformity, and ectropion. In patients with previous blepharoplasty or midfacelifts, minimal or no tissue can be resected. Instead, any midfacial advancement achieved is required to reconstruct the lower eyelid form and allow a canthoplasty or canthopexy to heal without undue downward traction on the repair. The surgeon must elevate the midface tissue in a very limited, safe fashion. Many current approaches to midfacial rejuvenation exist in a number of anatomic planes, with several fixation techniques. Some surgical approaches, such as surgery in a suborbicularis plane, may be inherently safer than others. Aesthetic micromanagement of the lower eyelid position and orbicularis muscle is possible. A useful test for assessing the amount of available midfacial tissue is provided.
KEYWORDS
Midfacial rejuvenation - blepharoplasty - aesthetic micromanagement
REFERENCES
- 1 Campiglio G L, Candiani P. Anatomical study on the temporal fascial layers and their relationships with the facial nerve. Aesthetic Plast Surg . 1997; 21 72
- 2 Yaremchuk M J. Subperiosteal and full-thickness skin rhytidectomy. Plast Reconstr Surg . 2001; 107 1585
- 3 Mendelson B C, Muzaffar A R, Adams W P. Surgical anatomy of the midcheek and malar mounds. Plast Reconstr Surg. 2002 (Sep); 110(3) 885-911
- 4 Owsley J Q. Lifting the malar fat pad. Plast Reconstr Surg . 1993; 91 463
- 5 Owsley J Q, Zweifler M. Midface lift of the malar fat pad: technical advances. Plast Reconstr Surg . 2002; 110(2) 674-685
- 6 McCord C D, Codner M A, Hester T R. Redraping the inferior orbicularis arc. Plast Reconstr Surg . 1998; 102 2471
- 7 Fogli A L. Orbicularis muscleplasty and facelift: a better orbital contour. Plast Reconstr Surg . 1995; 96 1560
- 8 Hinderer U T, Urriolagoita F, Vildosola R. The blepharo-periorbitoplasty: anatomical basis. Ann Plast Surg . 1987; 18 437
- 9 Trepsat F. Facelift of the malar, jugal and nasolabial regions. Ann Chir Plast Esthet . 1994; 39 597
- 10 Ramirez O M, Pozner J N. Subperiosteal minimally invasive laser endoscopic rhytidectomy: the SMILE facelift. Aesthet Plast Surg . 1996; 20(6) 463-470
- 11 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
- 12 Edelstein C, Balch K, Schorr N, Goldberg R A. The transeyelid subperiosteal midface-lift in the unhappy postblepharoplasty patient. Semin Ophthalmol . 1998; 13(3) 107-114
- 13 Hamra S T. The zygorbicular dissection in composite rhytidectomy: an ideal midface plane. Plast Reconstr Surg . 1998; 102(5) 1646-1657
- 14 Moelleken B. The superficial subciliary cheeklift, a technique for rejuvenating the infraorbital region and nasojugal groove: a clinical series of 71 patients. Plast Reconstr Surg . 1999; 104(6) 1863-1874
- 15 Gunter J P, Hackney F L. Plast Reconstr Surg . 1999; 103(7) 2029-2035
- 16 Finger E R. A 5-year study of the transmalar subperiosteal midface lift with minimal skin and superficial musculoaponeurotic system dissection: a durable, natural appearing lift with less surgery and recovery time. Plast Reconstr Surg . 2001; 15(107-5) 1273-1283
- 17 Hobar P C, Flood J. Subperiosteal rejuvenation of the midface and periorbital area: a simplified approach. Plast Reconstr Surg . 1999; 104(3) 842-851
- 18 Anderson R D, Lo M W. Endoscopic malar/midface suspension procedure. Plast Reconstr Surg . 1998; 102(6) 2196-2208
- 19 Sasaki G H, Cohen A T. Meloplication of the malar fat pads by percutaneous cable-suture technique for midface rejuvenation: outcome study (392 cases, 6 years' experience). Plast Reconstr Surg . 2002; 110(2) 635-654
- 20 Whitaker L A, Bartlett S P. Skeletal alterations as a basis for facial rejuvenation. Clin Plast Surg . 1991; 18(1) 197-203
- 21 Binder W J. Submalar augmentation: a procedure to enhance rhytidectomy. Ann Plast Surg . 1990; 24(3) 200-212
- 22 Binder W J, Moelleken B RW, Tobias G. Aesthetic facial implants. In: Facial Plastic and Reconstructive Surgery New York: Thieme Medical Publishers 2002
- 23 Campiglio G L, Candiani P. Anatomical study on the temporal fascial layers and their relationships with the facial nerve. Aesthetic Plast Surg . 1997; 21 72
- 24 Moelleken B. Rejuvenation of the upper and midface. In: Mathes et al., ed. Plastic Surgery Philadelphia: WB Saunders in press
- 25 Moelleken B. The superficial subciliary cheeklift, a technique for rejuvenating the infraorbital region and nasojugal groove: a clinical series of 71 patients. Plast Reconstr Surg . 1999; 104(6) 1863-1874