Triple-Layer Midface Lifting: Long-Term Follow-Up of an Effective Approach to Aesthetic Surgery of the Lower Eyelid and the Midface

Stevens, Hieronymus P; Willemsen, Joep C. N.; Durani, Piyush; Rasteiro, David; Omoruyi, O. J.

doi:10.1007/s00266-014-0345-z

Cited by 14 publications

(3 citation statements)

References 22 publications

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“…Several previous reports highlight these benefits, providing evidence for the efficacy and favorable outcomes associated with this technique. For instance, Stevens described the subciliary incision technique as providing better access to the lower eyelid fat compartments and allowing for more precise fat removal and repositioning [ 24 ]. He emphasized that this approach enables direct visualization of the lower eyelid structures, facilitating precise control over fat removal and achieving a smoother contour.…”

Section: Discussionmentioning

confidence: 99%

Advanced Facial Rejuvenation: Synergistic Effects of Lower Blepharoplasty and Ultrasound Guided Mid-Face Lift Using Polydioxanone (PDO) Threads

Park,

Jeong,

Park

2024

Aesth Plast Surg

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Background Traditional facial aging surgeries have risks and extended recovery times, leading to a demand for minimally invasive alternatives. PDO (polydioxanone) threads, which are absorbable sutures that stimulate collagen production and tissue contraction, offer improved aesthetic outcomes. This paper evaluates the combined use of PDO thread mid-cheek lift and lower blepharoplasty for facial rejuvenation. Methods This retrospective study compared outcomes in patients undergoing lower blepharoplasty combined with a mid-face lift using PDO threads versus those undergoing only lower blepharoplasty. Focused on individuals with baggy lower eyelids and pronounced nasolabial folds, outcome measures included the Modified Fitzpatrick wrinkle scale, Allergan® midface volume deficit scale, Width of inter zygomatic distance, Patient and Observer Scar Assessment Scale, and patient satisfaction questionnaires, assessed at baseline, 3 months, and 1 year postoperatively. Results The combined procedure demonstrated superior aesthetic outcomes and higher patient satisfaction compared to lower blepharoplasty alone. Improvements were more significant in wrinkle reduction, midface volume, and inter-zygomatic distance in the combined procedure group. Although the combined procedure had a longer mean operation time, scar assessment scores were similar between both groups, with no complications reported. Conclusion The combination of lower blepharoplasty and mid-face lift using PDO threads is a comprehensive and effective approach for facial rejuvenation. It significantly enhances wrinkle reduction, mid-face lifting, and patient satisfaction. Ultrasound-guided thread lifting, a method of assessing and performing mid-face lifting, proves to be safe and efficient. This approach holds promise as a future option in cosmetic anti-aging surgery, presenting a minimally invasive alternative with natural-looking results and reduced downtime. Level of Evidence II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://link.springer.com/journal/00266.

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Section: Discussionmentioning

confidence: 99%

Advanced Facial Rejuvenation: Synergistic Effects of Lower Blepharoplasty and Ultrasound Guided Mid-Face Lift Using Polydioxanone (PDO) Threads

Park,

Jeong,

Park

2024

Aesth Plast Surg

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“…Recurrence rates tend to be high. [13][14][15][16][17][18][19][20]32,33 MIDFACE is a minimally invasive procedure performed in the office under local anesthesia, avoiding the costs and risks associated with a trip to the operating room. MIDFACE is performed with the Ellman Dual Surgitron, an electrosurgical unit that generates high-frequency (4 MHz) radio waves that cause minimal thermal damage.…”

Section: Discussionmentioning

confidence: 99%

A Novel, Minimally Invasive Festoon Surgery: Mini Incision Direct Festoon Access, Cauterization, and Excision (MIDFACE): A 12 Year Analysis

Gupta¹,

Gupta

Bamberger

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Surgical festoon management often entails aggressive dissection, flaps, unsightly scars, prolonged recovery, and high recurrence rates. The authors present outcomes with subjective and objective evaluation of an office-based, novel, minimally invasive (1-cm incision) festoon repair: mini-incision direct festoon access, cauterization, and excision (MIDFACE). Methods: Charts of 75 consecutive patients from 2007 to 2019 were evaluated. Photographs of 39 patients who met inclusionary criteria were evaluated by three expert physician graders for festoon and incision visibility (339 randomly scrambled preoperative and postoperative photographs taken with and without flash and from four different views: close-up, profile, full-frontal, and worm’s eye) using paired t tests and Kruskal-Wallis tests for statistical evaluation. Surveys returned by 37 of 75 patients were evaluated for patient satisfaction and possible contributing factors to festoon formation or exacerbation. Results: There were no major complications in the 75 patients who underwent MIDFACE. Physician grading of photographs of 39 patients (78 eyes, 35 women; four men; mean age, 58 ± 7.7 years) demonstrated statistically significant sustained improvement in festoon score postoperatively up to 12 years regardless of view or flash. Incision scores were the same preoperatively and postoperatively, indicating incisions could not be detected by photography. Average patient satisfaction score was 9.5 on a Likert scale of 0 to 10. Possible factors for festoon formation or exacerbation included genetics (51%), pets (51%), prior hyaluronic acid fillers (54%), neurotoxin (62%), facial surgery (40%), alcohol (49%), allergies (46%), and sun exposure (59%). Conclusion: MIDFACE repair results in sustained improvement of festoons with an office-based, minimally invasive procedure with high patient satisfaction, rapid recovery, and low recurrence. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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“…11 If lower blepharoplasty is performed along with extended dissection of the midcheek area, surgical outcomes would be better than those obtained with conventional lower blepharoplasty alone. [12][13][14][15][16][17] Midface lift through the subciliary transcutaneous approach can shorten the lid height and restore the redistributed volume in the midface. 18,19 As a result, a three-dimensional attractive and youthful face is possible.…”

mentioning

confidence: 99%

Rejuvenation of the lower eyelid and midface with deep nasolabial fat lift in East Asians

Lee

Cha

Ko³

2023

Plastic &Amp; Reconstructive Surgery

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Background: Correcting infraorbital hollowness is an important procedure for midface rejuvenation. Sub-orbicularis oculi fat lift is a commonly used method. However, adipose tissue, which has been thought of as sub-orbicularis oculi fat, has recently been controversial. The objective of this study was to introduce a method of midface rejuvenation using deep nasolabial fat lift (MRDN) by means of lower blepharoplasty and to compare surgical outcomes between MRDN and lower blepharoplasty with fat transposition (LBF). Methods: The medical records of patients who had undergone midface rejuvenation with lower blepharoplasty between 2013 and 2020 were retrospectively reviewed. Questionnaires, digital photographs, and charts were used to evaluate the surgical outcomes and complications. The degree of aging was graded as mild, moderate, or severe. LBF and MRDN were used for mild and severe grades, respectively. For the moderate grade, the preferred surgical method of the two methods was selected and surgical outcomes were compared. The MRDN technique included LBF. Results: Postoperative satisfaction was significantly higher (P < 0.001), recurrence rate for tear trough (P = 0.046) and fat bulging (P = 0.005) was significantly lower, duration of swelling (P < 0.001) was significantly longer, and incidence of chemosis (P = 0.024) was significantly higher in the MRDN group than in the LBF group. Regarding lid malposition, transient retraction was higher in the LBF group, whereas cicatricial ectropion was higher in the MRDN group; however, these differences were not significant. Conclusion: MRDN is associated with higher patient satisfaction and surgical longevity without serious complications than LBF.

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Triple-Layer Midface Lifting: Long-Term Follow-Up of an Effective Approach to Aesthetic Surgery of the Lower Eyelid and the Midface

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cited by 14 publications

References 22 publications

Advanced Facial Rejuvenation: Synergistic Effects of Lower Blepharoplasty and Ultrasound Guided Mid-Face Lift Using Polydioxanone (PDO) Threads

Advanced Facial Rejuvenation: Synergistic Effects of Lower Blepharoplasty and Ultrasound Guided Mid-Face Lift Using Polydioxanone (PDO) Threads

A Novel, Minimally Invasive Festoon Surgery: Mini Incision Direct Festoon Access, Cauterization, and Excision (MIDFACE): A 12 Year Analysis

Rejuvenation of the lower eyelid and midface with deep nasolabial fat lift in East Asians

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