title: Subperiosteal Endotine-assisted vertical upper midface lift.
abstract: BACKGROUND
  In the typical upper midface lift, tissue fixation is usually accomplished through a series of sutures that may be time consuming, technically demanding, difficult to apply, and also require frequent rearrangement and adjustment.
  
  
  OBJECTIVE
  The use of an Endotine Midface (Coapt Systems, Palo Alto, CA) fixation device through a technique termed the subperiosteal Endotine-assisted vertical upper midface lift is described.
  
  
  METHODS
  Twelve patients underwent subperiosteal Endotine-assisted vertical upper midface lift, which included simultaneous forehead lift, blepharoplasty and Endotine-assisted transtemporal-transoral subperiosteal upper midface tissue release, verticolateral elevation and fixation of the upper midface.
  
  
  RESULTS
  The technique we used achieved a significant improvement of the eyelid-cheek complex and rejuvenation of the nasojugal groove as evaluated 6 months after surgery. Preoperative and postoperative assessments of the lower eyelid distance revealed a mean shortening of 5 mm +/- 2 mm.
  
  
  CONCLUSIONS
  The results confirmed that vertical upper midface lifts combined with Endotine-assisted midface fixation can be safely and predictably performed over the zygomatic muscle. This technique allows for simple adjustments of tension and position, thereby providing greater aesthetic control of cheek elevation and projection. It also achieves volume enhancement and projection of the midface tissue.
authors.affiliation: Department of Plastic and Aesthetic Surgery, University Hospital and Medical School of Göttingen, Göttingen, Germany.
authors.forename: Johannes Franz
authors.initials: JF
authors.lastname: Hönig