title: Anatomic comparison of the deep-plane face-lift and the transtemporal midface-lift.
abstract: OBJECTIVE
  To identify whether the deep-plane face-lift or the extended transtemporal subperiosteal midface-lift is more effective in correcting midfacial ptosis.
  
  
  METHODS
  Five cadaveric dissections were performed with a unilateral transtemporal subperiosteal midface-lift followed by a deep-plane face-lift on the same hemihead. Three suspension sutures were evaluated-transtemporal midface-lift, zygomaticofacial and melolabial sutures, and a deep-plane face-lift suture-to determine the degree of elevation on the nasolabial fold. Statistical analysis was performed to compare their effectiveness.
  
  
  RESULTS
  The melolabial suture elevates the nasolabial fold 43.2% more than the deep-plane suture (P = .03) and 29.2% more than the zygomaticofacial suture (P = .10). At no point did the deep-plane suture offer more elevation than either the zygomaticofacial or melolabial suture.
  
  
  CONCLUSIONS
  Midface-lifting surgery is challenging owing to the difficulty of adequately releasing the soft tissues overlying the zygomaticomaxillary region and resuspending them effectively. A comparison of the extended transtemporal midface-lift and deep-plane face-lift demonstrates the statistically significant advantage of the transtemporal midface-lift on elevating the nasolabial fold, particularly the melolabial suspension suture.
authors.affiliation: Section of Facial Plastic and Reconstructive Surgery, North Shore University Hospital, Manhasset, New York, USA. drjacono@gmail.com
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Jacono
authors.forename: Benjamin Collin
authors.initials: BC
authors.lastname: Stong
mesh_terms: D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010521:Periosteum / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology*; D015361:Rhytidoplasty / Q000379:methods*; D013537:Sutures; D016896:Treatment Outcome