ABSTRACT
IMPORTANCE: The value of this study is to evaluate outcomes of endoscopic forehead-midface-lift surgery. Many surgeons are reluctant to offer this procedure for fear of change in the shape and appearance of the eyelid. OBJECTIVE: To objectively evaluate the change in lateral canthal position following endoscopic forehead-midface-lift surgery. DESIGN: A retrospective review of consecutive patients undergoing endoscopic forehead-midface-lift and lower blepharoplasty procedures for cosmetic midface rejuvenation. SETTING: A private facial plastic surgery practice. PARTICIPANTS: Photometric data were obtained from before-and-after surgery images from 40 patients. MAIN OUTCOMES AND MEASURES: All photographs were analyzed to determine the horizontal width, vertical height, palpebral fissure width, or angle between the medial and lateral canthi. The right and left eyes were evaluated independently, with the results analyzed using a 2-tailed paired t test with a confidence interval of 0.05 or less (required for statistical significance). RESULTS: The results indicated no statistically significant change in the horizontal width (right, P = .25; left P = .07), vertical height (right, P = .99; left, P = .72), palpebral fissure width (right, P = .28; left, P = .48), and angle of the lateral canthus (right, P = .99; left, P = .30) before and after surgery. CONCLUSIONS AND RELEVANCE: The endoscopic forehead-midface-lift is a reliable method of addressing midface descent. This study objectively identified no significant differences in the position of the lateral canthus before and after surgery. LEVEL OF EVIDENCE: 4.
Subject(s)
Blepharoplasty/methods , Endoscopy/methods , Eyelids/anatomy & histology , Rhytidoplasty/methods , Eyelids/surgery , Female , Follow-Up Studies , Forehead , Humans , Male , Outcome Assessment, Health Care , Photography , Rejuvenation , Retrospective StudiesABSTRACT
Enhancing nasal tip definition requires a three-dimensional approach encompassing both form and function. Dome refinements achieved during surgery should be created with sufficient integrity to withstand postoperative healing forces. Stabilizing the nasal base is the first component of dome alterations and prevents loss of tip rotation and projection. Structural grafting can be used to enhance tip definition and at the same time adds support to the cartilaginous framework. Tip shield grafts camouflage dome asymmetries, establish the tip-defining point, and enhance the supratip break. Shield grafts can be placed in all skin types with appropriate contouring and camouflaging techniques.
