Mag-5: a magnificent approach to upper and midfacial "magic".

MAG-5 is an operation with five surgical components: (1) a lateral emphasis frontal lift with (2) corrugator resection, (3) lower blepharoplasty, (4) extended two-layered canthopexy, and (5) a full (or partial) subperiosteal malar release and midcheek lift assisted by an absorbable suture securing the malar tuft periosteum and fibrous tissue to the orbital rim. The procedure rejuvenates and restores the face or transforms it when, and if, transformation is the desire.

The open coronal approach to forehead rejuvenation.

The coronal or frontal lift is a simple operation and the most effective tool for brightening and refreshing facial appearance. It becomes even more effective when combined with canthopexy, midcheek lifting, and lower lid surgery. Its rejuvenation and beauty-enhancing effects are awesome, and much of its benefit is transferable to endoscopic lifts or lateral juxta-brow, temple excisions, if one takes the time to master the details.

Correcting suborbital malar hypoplasia and related boney deficiencies.

The uncomplicated correction of tear trough and related nasojugal groove deformities continues to elude many surgeons. In spite of available fillers and other "implantables," the author contends that silicone elastomer tear trough implants continue to be the most effective method for correcting the true boney tear trough deformity, while malar-orbicularis-periosteal release and elevation with secure 2-layered canthopexy offers optimal correction for the nasojugal groove. Here is a guide to his technique and materials.

A key to canthopexy: the tarsal strap. A fresh cadaveric study.

BACKGROUND: This article describes a poorly understood yet clinically significant eyelid structure the authors have labeled the tarsal strap. The tarsal strap anchors the tarsus to the periosteum of the inferolateral orbit. Releasing this tethering band is the cornerstone of achieving lasting, superior surgical results during lateral canthopexy and periorbital restoration in aesthetic and reconstructive surgery. METHODS: An 87-year-old, male, fresh cadaveric head of Caucasian origin was studied. The dissection was repeated on 15 cadaver heads, including both male and female cadavers, from various ethnic backgrounds, to confirm the anatomy of the tarsal strap described in this article. RESULTS: The tarsal strap was identified in all 16 cadaver dissections and appeared in a consistently similar location. CONCLUSIONS: Until now, the tarsal strap has been a poorly understood entity, despite being an anatomically and clinically significant eyelid structure. Knowledge of its significance is essential to restoring the lateral canthus and returning periorbital structures to their youthful state. It should be routinely sought out and properly released.

Asian blepharoplasty.

The author describes blepharoplasty and related techniques to achieve fresh, youthful, and attractive eyes in the Asian patient. Emphasis is on maintaining ethnic integrity and recognizing the need for appropriate adjunctive procedures. (Aesthetic Surg J 2002;22:558-568.).