The concepts of craniofacial surgery developed by Paul Tessier have ev
olved through four different phases: reconstruction, restoration, remo
deling, and rejuvenation. Subperiosteal undermining of the upper, mid,
and lower face allowed surgeons not only to reposition the soft tissu
es at the level of the bony insertion but also to remodel the craniofa
cial skeleton by either reduction or augmentation. Subperiosteal under
mining of the face can be applied to treat a series of aesthetic defec
ts of congenital, traumatic, or degenerative conditions.