A patient presenting to a facial plastic surgeon with lower eyelid aging often has accompanying midface descent. Many surgical options exist to address these deformities. Blepharoplasty techniques include both the transcutaneous skin-muscle flap as well as the transconjunctival approach. The midface can be addressed via a multitude of techniques, including percutaneous suspension of the malar fat pad, deep plane dissections, subperiosteal and endoscopic midface lifts, and transorbital approaches. Patients who have some midface ptosis but do not meet the standard criteria for formal midface lifting, or who want to avoid the extended recovery associated with such techniques, could benefit from less invasive procedures. We propose the extended skin muscle blepharoplasty to address midface descent and lower lid aging to patients as an alternative to formal midface lifting. The extended skin muscle blepharoplasty is an excellent technique for patients with orbicularis hypertrophy, skin redundancy, a tear trough deformity, and premalar ptosis, as it addresses each of these deformities with minimal downtime. Results for patients with mild but visible midface descent are gratifying.
Rhytidectomy has been performed for over 100 years, but only more recently has it become generally accepted by society. Recent improvements in access to information has produced more public awareness of the possible aesthetic enhancements. Additionally, there has been a trend for the younger patient to seek cosmetic surgery, often requesting procedures with minimal incisions and less downtime. The mini-lift, with its decreased operating time and expense, rapid recovery, as well as more limited incisions and tissue elevation, is an ideal procedure for patients with a smaller degree of cheek and neck laxity. We describe our concept of the mini-lift and address what results can be expected.
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