My Surgical Approach to the Midface Using a Multi-Pronged Approach; Fat Transfer, Cheek Implants, the Endoscopic Midface Lift

Session Description

There have been numerous techniques used to approach the midface in facial rejuvenation surgery. Volume loss, ligament laxity, soft tissue descent, and bony resorption all contribute to aging of the midface. Volume augmentation with injectable fillers, autologous fat, and cheek implants are valuable tools to treat deficiency in this area. However, these techniques may not lift the ptotic cheeks to their desired position. The endoscopic subperiosteal midface lift helps to reposition the entire cheek complex en bloc in a vertical manner, simultaneously lifting and imbricating the cheek to give it more volume. Malar suspension with or without buccal fat suspension into the submalar compartment may be used. In some patients, this may eliminate the need for additional volume augmentation. In others, a combination of volume augmentation and endoscopic midface lifting is employed. The author describes his algorithm as to when to employ each of these techniques, sometimes using a combination of these techniques, to rejuvenate the midface.