Suture midface suspension：Case Study（1）
Head & Face Medicine 2006, 2:35
doi:10.1186/1746-160X-2-35
Suat H Ugurbas, Robert A Goldberg, John D McCann, Norman Shorr, Rachna Murthy and Guy J Ben Simon*
*Corresponding author: Guy J Ben Simon guybensimon@gmail.com
Author Affiliations
Orbital and Ophthalmic Plastic Surgery Division, Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine, UCLA, Los Angeles, California, USA
The electronic version of this article is the complete one and can be found online at : http://www.head-face-med.com/content/2/1/35
Received : 6 August 2006
Accepted : 1 November 2006
Published : 1 November 2006
© 2006 Ugurbas et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
（http://www.head-face-med.com/content/2/1/35）
Abstract
Objective
To describe a simple and effective facelift technique useful as an adjunct to other oculoplastic procedures
Methods
Retrospective, non-comparative case series. Thirty five patients undergoing suture midface suspension from 1998 to 2000. Suspension sutures were passed from the nasolabial fold to the temporalis fascia to elevate the midface and the corner of the mouth.
Results
A satisfactory and stable outcome is obtained in 2 years of follow up.
Conclusion
Suture midface suspension is a safe and effective technique for the management of midface descent.
Background
As our concept of facial rejuvenation has evolved, the midface has become an area of interest to oculoplastic surgeons. The midface is involved in the extended eyelid complex and also is affected by descent of the facial tissues during the aging process of the body. Drooping of facial skin and deepening of the nasolabial sulcus are characteristic features of midface descent. Several surgical methods that achieve Vertical elevation are available to address this problem[1]. Today, the surgical techniques are shaped by an improvement in inert suture materials and interest for less invasive surgeries by the public. Herein, we describe and report the results of a simple and effective treatment for midface descent which is less invasive than the traditional deeper plane facelift surgeries. The purpose of the current paper is to describe two years follow up of 35 patients with mid-face descent of various causes who were operated using suture mid-face cable suspension at the division of orbito-facial surgery, Jules Stein Eye Institute.
Methods
We reviewed the charts of 35 patients who underwent suture facelift surgery and at least 2 years of follow up after the operation. In this series, the procedure was performed either as primary surgery or as an adjunct to other oculoplastic procedures such as upper and lower blepharoplasty, endoscopic brow lift and neck liposuction.
All patients were assessed using pre- and post-operative full face photographs. Digital images were taken and recorded in the electronic medical record of the oculoplastic registry at the Jules Stein Eye Institute at each postoperative visit. Images were reviewed by two independent observers.
Surgical technique
The surgical procedure is carried out under Local anesthesia with Intravenous sedation. The midface suture suspension procedure is performed through a Temporal incision. A marking is made 1 cm lateral to the nasal flare of the nostril on the nasolabial fold and a further marking 1 cm inferior to the previous, following the contour of the nasolabial fold. Two lines are drawn from the nasolabial fold markings to the temporal hair line. The first line passes 1 cm lateral to the lateral canthus and the second line runs parallel to the first, passing 1 cm lateral to it. These lines are extended to the temporal incision site which is marked 1 cm above the hairline (Figure 1).
The temporal incision is made with a number 15 Bard Parker blade approximately 1 cm above the hairline area. Dissection is made directly through to the level of D eep temporalis fascia (Figure 2). Two small stab wounds are made at the point of the nasolabial markings.
Figure 1. Midface suspension suture lines are marked.
Ugurbas et al. Head & Face Medicine 2006 2:35 doi:10.1186/1746-160X-2-35
Figure 2. The incision is extended to the level of the deep temporalis fascia. Ugurbas et al. Head & Face Medicine 2006 2:35 doi:10.1186/1746-160X-2-35
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