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Transoral-Transtemporal Endotine-Assisted Endoscopic Midface Lift (TTEEM): Technical Considerations and Objective
Marc Levin1, Jordan Kai Simmons2,3, Andrew Frankel3
1Levin Facial Plastic Surgery, Facial Plastic Surgery, California, United States, Beverly Hills.
Introduction:
Durable correction of midfacial descent remains technically challenging, and no single operative approach has emerged superior. The transoral-transtemporal Endotine-assisted technique has been described yet lacks robust long-term outcome data. Objective & Hypotheses: Evaluate long-term effectiveness of transoral-transtemporal Endotine-assisted endoscopic midface lift (TTEEM).
Study Design:
Retrospective cohort study Methods: Any patient undergoing TTEEM lift with photographic documentation from 2003-2025 were included (n=113, 97.3% female, mean age 61.7 years). Photographs were assessed using a validated midface scoring scale, GAIS, and intraclass correlation coefficients.
Results:
Statistically significant improvements were observed: infraorbital hollow (1.71 to 1.24, p<0.00001), upper cheek fullness (2.01 to 1.27, p<0.00001), lower cheek fullness (1.71 to 1.36, p<0.0001), and nasolabial fold depth (1.58 to 1.32, p=0.0007). Mean GAIS score was 2.96. Follow-up photographic analysis averaged 2.6 years, extending to 17 years.
Conclusion:
TTEEM lifts produce durable improvements in midfacial contour, and is worthy of consideration when planning midface lift surgery.