MASK LIFT AND FACIAL AESTHETIC SCULPTURING

Paul Tessier started the great adventure of sculpturing the malformed face more than 30 years ago. Key procedures such as subperiosteal diss ection and lifting of the facial mask, bone grafting from a cranial si te of harvest, and lateral canthopexies have been utilized and have wi thstood the trial of time in thousands of patients. The mask lift with facial aesthetic sculpturing, a newcomer in aesthetic surgery, is an extrapolation of these craniofacial procedures. It is a different and revolutionary approach to the aging face that seeks to normalize, reju venate, and embellish the face through a subperiosteal lift of the fac ial mask and transformation of the underlying structures. Facial aesth etic sculpturing refers to the aesthetic sculp turing of the facial sk eleton. It allows us to equilibrate the components of a malformed face and normalize it by osteotomies, displacements in three dimensions, a nd bone overgrafting; to normalize the forms of an unattractive face a nd to embellish it by harmonization of the skeletal volume; and to res tore the forms of an aging face and to rejuvenate it by augmenting res orbed bone, reducing hypertrophic bone, and lifting the facial mask. M y experience includes 350 patients operated on from 1981 to 1992, of t hese, 200 cases were purely aesthetic, 150 functional. The complicatio ns encountered have been few. Tile technique described offers an appro priate response to the different problems of aging and embellishment o f a face, whether for reequilibration of osseous volumes or for saggin g of soft tissues of the superior two-thirds of the face. Facial aesth etic sculpturing finds application also in some malformations and acqu ired deformities and in young faces with unsightly features.