The subperiosteal, drill hole, midface lift

Area of Science:

• Plastic Surgery
• Facial Rejuvenation Surgery

Background:

• Midface aging leads to descent of facial tissues.
• Various surgical techniques aim to elevate the midface.
• Standard methods have limitations in achieving durable results.

Purpose of the Study:

• To describe and evaluate a new surgical technique for subperiosteal midface lift using drill holes and permanent sutures.
• To compare this technique with standard preperiosteal and subperiosteal midface elevation methods.

Main Methods:

• Retrospective, comparative, non-randomized study of 35 midface lifts (2009-2013).
• Techniques included subperiosteal drill hole with sutures, preperiosteal with Vicryl sutures, and subperiosteal with Endotine device.
• Pre- and post-operative photos were graded for lower lid/cheek junction malposition (0-3 scale).

Main Results:

• All techniques showed no significant complications with >4 months follow-up.
• The drill hole group (average grade 0.65) showed greater improvement than Vicryl (0.75) and Endotine (0.7) groups.
• The drill hole group achieved the largest improvement score, despite having the most severe pre-operative malposition.

Conclusions:

• The subperiosteal drill hole technique is an effective method for functional midface elevation.
• This technique provides adequate and durable vertical elevation.
• It does not depend on periosteal integrity or specialized fixation devices.