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Updated: Jun 13, 2026

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Orbitomalar suspension during high SMAS facelift.

Steven R Cohen1, Don O Kikkawa, Bobby S Korn

  • 1Division of Plastic Surgery and the Division of Oculoplastic Surgery, University of California-San Diego, CA 92122, USA. scohen@facesplus.com

Aesthetic Surgery Journal
|May 6, 2010
PubMed
Summary

Orbitomalar suspension (OMS) during high SMAS facelift offers improved cheek elevation and blending of the eyelid-cheek junction. This technique demonstrated a low complication rate, with minor issues like palpable knots and transient ectropion being effectively managed.

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Area of Science:

  • Plastic Surgery
  • Aesthetic Surgery
  • Facial Rejuvenation

Background:

  • Traditional facelift techniques face limitations in the orbitomalar region and centrofacial approach.
  • Superficial musculo-aponeurotic system (SMAS) dissection can be incomplete, impacting aesthetic outcomes.

Purpose of the Study:

  • To evaluate the efficacy and complication rates of Orbitomalar Suspension (OMS) in high SMAS facelift.
  • To assess OMS's ability to enhance aesthetic results and improve eyelid-cheek junction blending.
  • To determine the risk of lower eyelid ectropion associated with the OMS procedure.

Main Methods:

  • Sixty patients underwent OMS as part of a high SMAS facelift and lower blepharoplasty procedure.
  • The technique focuses on superior-medial cheek repositioning and lower eyelid stabilization.

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  • The primary goal was to reduce the incidence of postoperative ectropion.

    • Main Results:

    • Minor complications included palpable Vicryl knots in three patients, with one requiring surgical removal.
    • One case of lower eyelid malposition (ectropion) occurred but was successfully revised.
    • Transient lower eyelid malposition resolved within four weeks in two patients.

    Conclusions:

    • OMS effectively complements high SMAS facelift by adding medial and superior cheek elevation.
    • The procedure achieves excellent blending of the lower eyelid-cheek junction.
    • OMS presents a low risk of lower eyelid malposition when performed with high SMAS facelift.