gms | German Medical Science

49. Jahrestagung der Deutschen Gesellschaft für Plastische und Wiederherstellungschirurgie (DGPW)

Deutsche Gesellschaft für Plastische und Wiederherstellungschirurgie e. V.

06.10.-08.10.2011, Ulm

Vertical subperiosteal midfacelift: Suspension sutures transcutaneous versus transoral

Meeting Abstract

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Deutsche Gesellschaft für Plastische und Wiederherstellungschirurgie. 49. Jahrestagung der Deutschen Gesellschaft für Plastische und Wiederherstellungschirurgie (DGPW). Ulm, 06.-08.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11dgpw034

DOI: 10.3205/11dgpw034, URN: urn:nbn:de:0183-11dgpw0345

Veröffentlicht: 7. Dezember 2011

© 2011 Hoenig.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Introduction: With age the soft tissue of the face tends to follow the forces of gravity more vertically rather than oblique. The cheeks begin to look saggy or flat, lower eyelids enlarges can become puffy or hollow and circles begin to appear under the eyes. This encourages performing an upper midface lift in a more vertical direction. Usually tissue fixation is accomplished by a series of sutures position for greater aesthetic control of cheek tissue elevation using a transoral or a transcutaneous approach.

Material and method: Using this technique to provide a natural and improved facial rejuvenation of the upper midface and the lower lid we analysed the suspension suture techniques via transcutaneous versus intra an oral approach on 58 female patients with a mean age of 44,8 +/- 8,3 years. We compare operation time, durability, complications and post op swelling. 31 patients were treated via a transcutaneous procedure and 27 females via a transoral approach.

Results: The results confirmed that vertical upper midface lifts in patients with an intraoral approach have less post operative swelling that tends to disappear faster, probably due to some drainage intraoraly approach. The operation time was 20 +/- 7 min minutes shorter in average using the transcutaneous suspension suture method. Using the transoral approach we found in 3 cases a partial wound dehiscence (10%) but no infection. In transcutaneous approaches we saw in 3 cases small dimples, (10%) but not detected and corrected intraoperatively.

Discussion: Both vertical midface suspension techniques are simple and allow adjustments of tension and position for greater aesthetic control of cheek elevation and projection. They give volume enhancement and projection of the midface tissue. Therefore the vertical subperiosteal midfacelift is an effective and safe procedure via an intra oral as well as a transcutaneous approach. This introduced procedure is an exciting feature that has evolved into a very useful modality. It gives natural and improved facial rejuvenation.

Conclusion: In case of extreme sagging of the midface and marked nasolabial folds the intraoral approach assures sufficient subperiosteal mobilisation and gives the possibility to easily distribute the weight of the elevated soft tissues over 2 or 3 cheek suspension sutures. This technique tends to give better long lasting results in selected cases. In indicated cases we prefer the transcutaneous approach as standard procedure for simplicity and shorter operation time. However the transoral approach has certain advantages in selected cases, as shown.