Summary
We describe a novel procedure for an anatomically-based face lift to correct vertical
vectors in the ageing face. It has the advantage of surgical simplicity, minimal tissue
removal and minimal risk. It provides an effective readjustment of cheek volume and
correction of periorbital hollowness. Natural facial expression is preserved largely
because there is no change in the position of the lateral canthus.
The cheek is mobilised subperiosteally through a blepharoplasty incision. A second
dissection is made via a short temporal incision, to join the infraorbital dissection.
A Hagedorn needle is then inserted through a point inferior to the lateral canthus
and in line horizontally with the nasal ala. It is passed to the orbital incision,
charged with a loop of suture material, and pulled down again to the cheek incision,
from where it is pushed back to the orbit to suspend the cheek. The upper border of
orbicularis oculi is fixed firmly to the temporalis aponeurosis at the level of the
temporal incision. We now frequently use an Endotine Midface device for fixation.
Of the first 150 patients, results were excellent or good in 145.
This represents a revival of the subperiosteal mask lift, and abandons the use of
endoscopic techniques. In spite of its simplicity, the operation involves subperiosteal
dissection as well as delicate eyelid surgery that necessitate plastic surgical skill.
Keywords
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Article info
Publication history
Published online: June 14, 2007
Accepted:
May 1,
2007
Received:
November 16,
2006
Identification
Copyright
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
