Subperiosteal rejuvenation of the midface and periorbital area: A simplified approach

A simplified approach to subperiosteal midface rejuvenation is presented. T he technique was developed through experience with 60 subperiosteal face li fts over an 8-year period. Because it does not involve a lower eyelid incis ion, there is no risk of ectropion, yet the midfacial structures and orbicu laris oculi muscle can be elevated easily and precisely. The procedure can be performed alone but is more commonly performed in conjunction with brow lift and traditional SMAS dissection of the lower face and neck. The benefits of this subperiosteal approach to the midface are powerful ele vation of the midfacial structures, improvement of the nasolabial folds, en hancement of the cheek prominences, smoothing of the nasojugal folds, and t ightening of the orbicularis oculi. The procedure is pet-fanned through sma ll incisions in the temple and gingival sulcus. The operation is technicall y straightforward and poses little risk to neurovascular structures. Concer ns over prolonged swelling have not materialized. There have been no instan ces of lower lid or canthal abnormalities.