Transblepharoplasty endoscopic subperiosteal midface lift

Area of Science:

• Plastic Surgery
• Ophthalmology
• Facial Rejuvenation Techniques

Background:

• Transblepharoplasty midface lifts aim to rejuvenate the lower eyelid and midface.
• Traditional techniques carry risks of facial nerve injury, bleeding, and muscle denervation.
• Endoscopic approaches offer enhanced visualization for dissection.

Purpose of the Study:

• To describe an endoscopic technique for transblepharoplasty midface lift.
• To highlight modifications for preventing complications and improving fixation.
• To detail methods for achieving a smooth lower lid contour.

Main Methods:

• Endoscopic dissection for precise identification and release of flap structures.
• Preservation of the zygo-orbicular nerve plexus and associated muscles.
• Suturing of periosteal and deep temporal fascia layers for flap fixation.
• Use of slowly absorbable polydioxanone sutures.
• Trimming of orbicularis muscle to refine contour.

Main Results:

• Complete observation via endoscopy prevents facial nerve injury and bleeding.
• The technique preserves the zygo-orbicular nerve plexus, avoiding muscle denervation.
• Modified suturing provides secure fixation for lower eyelid and midface suspension.
• Use of absorbable sutures avoids issues with permanent sutures in thin skin.
• Muscle trimming results in a smooth lower lid appearance.

Conclusions:

• The described endoscopic transblepharoplasty midface lift technique enhances precision and reliability.
• Modifications significantly decrease complication rates and patient morbidity.
• This approach offers improved outcomes for lower eyelid and midface rejuvenation.