察爾斯大夫 美麗殿堂 Dr. Charles Meridien Palace

Elevation of the Malar Fat Pad With a Percutaneous Technique（5） 

RESULTS

At 3 months after surgery, all patients had significant elevations of their malar fat pads, with the exception of 2 early patients, who underwent revision surgery, with satisfactory results. The elevation was of an extremely natural appearance. Excellent volume replacement of the cheek region was obtained. Results, in the senior author's opinion, were improved over those seen in deep-plane face-lifting with malar fat pad fixation. The average malar pad elevation before creation of the temporal pocket was 2 to 3 mm. After the surgical procedure incorporated the creation of the temporal pocket, 4 to 5 mm of elevation was uniformly achieved.

Temporary asymmetries were seen in 8 patients, but resolved within the 3-month period. Temporary unilateral pain complaints were expressed by 3 patients, but also resolved within the 3-month period. Two patients, as mentioned above, underwent revision surgery to remove the palpable temple polytef bolster used in the early subcutaneous fixation technique.

All patients at 1 year after surgery (excluding the exceptions mentioned above) have maintained their malar elevation. These results are in contrast to those seen with deep plane face-lifting, after which the senior author has seen a regression of malar fat pad elevation in some of his (and other surgeons') patients. In fact, the technique provides an easy, minimally invasive "tune-up" in the malar area for rejuvenation of patients with previous face-lifts (Figure 5, Figure 6, and Figure 7).

Figure 5.

A, Preoperative photograph of 42-year-old patient with mild malar ptosis. B, Postoperative photograph taken 1 year after closed technique.

Figure 6.

A, Preoperative photograph of 50-year-old patient with more-pronounced malar ptosis. B, Postoperative photograph taken 1 year after closed technique.

Figure 7.

A, Preoperative photograph of 49-year-old patient before surgery of the midface, jowls, and neck. B, Postoperative photograph taken after open technique (face-lift) and tip rhinoplasty. C, Preoperative oblique view. D, Postoperative oblique view.

No facial nerve problems, no excessive pulling, and no muscle fixation problems were noticed. There were spots of bruising in many patients, but they could generally be covered with makeup after about 72 hours. Four patients had prolonged infraorbital edema that required 2 weeks to resolve.