Subperiosteal face lift: a 200-case, 4-year review

Area of Science:

• Plastic Surgery
• Facial Rejuvenation
• Aesthetic Surgery

Background:

• Significant ptosis of midface soft tissue is a common concern.
• Subperiosteal facelift is a surgical approach to address aging in the upper and middle face.
• Previous rhytidectomy may influence surgical planning.

Purpose of the Study:

• To review a 4-year series of subperiosteal facelifts in 200 patients.
• To emphasize the handling of the zygomatic arch during the procedure.
• To evaluate the efficacy and complication rates of the subperiosteal facelift technique.

Main Methods:

• A retrospective review of 200 consecutive subperiosteal facelift cases over 4 years.
• Dissection of the maxilla, zygoma, periorbital areas, and anterior zygomatic arch via gingivo-buccal or subciliary incisions.
• Posterior zygomatic arch dissection in a plane superficial to the innominate fascia.
• Concurrent brow lift (endoscopic or coronal) and dissection of lateral orbital rims.

Main Results:

• The primary indication was significant midface soft tissue ptosis.
• Overall complication rate was 5%, including transient nerve weakness and hematoma.
• Excellent aesthetic outcomes were achieved, with notable improvement in eyebrow, lateral canthus, and midface elevation.
• 13% of patients required a concurrent upper blepharoplasty.

Conclusions:

• The subperiosteal facelift is a reliable procedure for rejuvenating the upper and middle thirds of the face.
• Systematic posterior approach to the zygomatic arch simplifies the surgery and minimizes facial nerve injury risk.
• The technique yields excellent aesthetic results with a low complication profile.