The temporal endoscopic midface lift - centrofacial rejuvenation without facial scars

Abstract

Aim: The author describes a new endoscopic midface lifting technique using solely temporal access and evaluates its advantages and perspectives. Methods: This is a single-surgeon case study. Through a short temporal incision, dissection is performed along a single plane connecting the superficial surfaces of both the facial and temporal superficial musculoaponeurotic system (SMAS) layers. Subsequent midface dissection divides the malar fat pad into the deeper and superficial parts. A new concept of a combination high malar SMAS lift and internal skin flap anchorage that provides long-term stability is described. Results: The temporal endoscopic midface (TEM) lift technique resulted in good objective results with high patient satisfaction. The temporal access allowed proper vertical vector correction of the sagging centro-facial structures. The resulting scar was inconspicuous and hidden in the hair bearing skin, and its length was measured between 5-6 cm. A conversion to the conventional long facial scar approach was completely avoided. Conclusion: The TEM lift is a new and effective procedure for facial rejuvenation, especially the midface and cheek. The results illustrate the importance of internal anchorage of both the midface SMAS and skin flap. These are the keys to longlasting and pleasing results. The procedure is best suited for younger men and women with little or no neck skin laxity.

Clinical anatomy considerations on the muscular and vascular components of the midface by ultrasonographic imaging

“…A protruding zygomatic bone and an abundance of superficial fat in the midface contribute to a younger-looking face, whereas aging of the midface is associated with a decrease in fat volume and the subsequent sagging of soft tissues. The midface is, therefore, an important anatomical area for facial rejuvenation procedures (Cotofana et al, 2015;Haffner, 2016). Achieving the best clinical outcomes without undesirable side effects requires accurate anatomical knowledge of the three-dimensional (3D) locations and depths of the various midface muscles and vessels and their surrounding structures (Spiegel & DeRosa, 2005;Surek et al, 2015).…”