Midface lift using a minimally invasive technique and a novel absorbable suture.
BACKGROUND
Midface rejuvenation is a minimally invasive procedure designed to correct early ptosis of the cheeks and deepening nasolabial folds. Implementation of this technique requires a detailed understanding of the anatomy of this region in addition to recognizing the vectors of change that occur over time as one matures. Finally, aesthetic competence and requisite surgical skills are required to restore the midface in a minimally invasive fashion.


OBJECTIVE
To describe a new minimally invasive approach to facial rejuvenation using a novel absorbable suture with segmented stabilizers that allows for a superolateral reversal of the senescent changes of the midface.


METHODS
In a case series study, 30 patients with aging changes of the midface signed informed consent to have this procedure done. An incision was made in the preauricular area, followed by hydrodissection with tumescent anesthesia and blunt dissection with the aid of a 4-mm spatula cannula. Two angiocatheters (14GA 3.25 IN, 2.1 x 83 mm, 14 gauge) were tunneled through the malar fat pad and pierced the skin just lateral to the nasolabial fold. The angiocatheter was then removed and the suture tethered to facilitate the proper amount of lifting entirely in the subcutaneous supra-SMAS plane and anchored superolaterally to the temporalis fascia. The segmented stabilizers anchored themselves in multiple directions but ultimately lifted the tissues of the midface.


CONCLUSIONS
This technique uses the multidirectional segmented stabilizers of the Monograms to counteract the downward displacement of the malar fat pad while simultaneously softening the nasolabial fold. This is a minimally invasive technique that addresses the multiple factors involved in the senescent changes of the midface. Proper patient selection, good aesthetic judgment, and surgical competence are required to restore the midface in a minimally invasive fashion. The objective of this study was to report a novel approach to midfacial rejuvenation using the Monograms. This cross-hatched suture achieves simultaneous malar fat pad elevation and nasolabial fold effacement. The midface lift adds another vital dimension to panfacial augmentation.
Bisaccia
Emil
E
Department of Clinical Dermatology, College of Physicians & Surgeons, Columbia University, New York, New York, USA.
Kadry
Razan
R
Rogachefsky
Arlene
A
Saap
Liliaana
L
Scarborough
Dwight A
DA
D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D015361:Rhytidoplasty / Q000379:methods*; D015595:Skin Aging; D013536:Suture Techniques; D013537:Sutures