Application Of Multi-point And Multi-level Suspension And Fixation Through Palpebral Margin Incision In Midface Lift

ObjectiveTo explore the clinical effect of the technique through palpebral margin incision,multi-point,multi-level suspension as well as fixation by using facial soft-tissue spaces of the midface to lift the midface.MethodsA total of 65 patients in this group were all aging midface patients from The First Affiliated Hospital of Fujian Medical University from October 2017 to October 2019.Among them,47 patients underwent primary blepharoplasty and midface lift in the meantime.Additionally,18 patients which includes 5 patients with lower eyelid retraction or ectropion after blepharoplasty undergo secondary midface lift after blepharoplasty.The preseptal space was separated under orbicularis oculi muscle by palpebral margin incision.The orbicularis retaining ligament and the tear trough ligament were severed through preperiosteal plane of dissection,and the preseptal space was connected with the premaxillary space and the prezygomatic space.The malar fat pad and superficial fascia were suspended vertically and fixed on the periosteum of the orbital margin by selecting the inner,middle and outer points of the infraorbital margin.The orbicularis oculi muscle was suspended and fixed superolaterally at the lateral orbital periosteum.Therefore,the midface could be lifted by multi-point,multi-level suspension and fixation.The patients were interviewed by telephone according to the FACE-Q score standard to investigate the satisfaction with the results of the operation between the patients undergoing the first operation and the patients undergoing the second operation.The two groups of data were statistically analyzed by SPSS20.0software.ResultThere were 65 cases in this group,and the incision healed in one stage.One case was eyelid from eyeball occurred around one month after the primary blepharoplasty,while the tarsal strip lateral canthoplasty was performed which was a great remedy for the complication and it was well corrected after operation.The other one case had a local protuberance of lateral lower eyelid in the early stage after operation,and it was improved after 3 months by using hotcompress and lid massaging.No complications occurred in the rest.The average follow-up time was 1 to 12 months,and 50 patients received effective telephone follow-up,with 36 cases of primary midface life and 14 cases of secondary midface lift after blepharoplasty.The FACE-Q scores of the two groups were high and the surgical results were satisfactory.There was no statistical difference in FACE-Q score between the two groups.Conclusion1.At the same time of eyelid blepharoplasty,multi-point and multi-level suspension and fixation through palpebral margin incision in midface lift can effectively improve the sagging tissue in the midface,improve the concave area in the midface,make the nasolabial groove shallow,and restore the midface rejuvenation.2.This surgical method is simple and practicable by using facial soft-tissue spaces of the midface,which has the characteristic of little trauma,less bleeding,less complications and good clinical effect for the patient.3.This surgical method is a good choice for restoring the rejuvenation of the midface,also suitable for secondary midface rejuvenation after blepharoplasty or complicated with lower eyelid retraction and ectropion.