The Role of the Midface Lift in Perioral Rejuvenation

ABSTRACT

As is true for all areas of the face, the etiology of perioral aging is multifactorial and necessitates a comprehensive approach if correction is to be optimal. Infraorbital aging in the midface is characterized by descent of soft tissue, loss of tissue volume, change in anatomy of the nasolabial fold, and deepening of orbicularis wrinkles. As the midface descends and deflates, there is concomitant lengthening and thinning of the upper lip and subtle descent of the lateral oral commissure. The technique used by the authors addresses midfacial aging using vertical elevation and fixation of malar soft tissue combined with redraping (tightening) of the orbicularis muscle. The important technical point regarding perioral rejuvenation is that the tendonous origins of the zygomaticus major and minor and the levator labii superioris are components of the cheek soft tissue complex that is vertically elevated. This anatomic fact creates at least the possibility that, along with some elevation of the oral commissure, shortening of the upper lip can occur.

KEYWORDS

Midface - oral commissure

REFERENCES

• 1 Gray H. Anatomy of the Human Body.  Philadelphia: Lea & Febiger; 1959
• 2 Hester T R, Codner M A, McCord C D, Nahai F, Giannopoulos A. Evolution of technique of the direct trans-blepharoplasty approach for the correction of lower lid and midfacial aging; maximizing results, minimizing complications: a 5-year experience.  Plast Recontr Surg . 2000;  1 393-406
• 3 Hester T R. Evolution of lower lid support following lower/ midface rejuvenation.  Clin Plast Surg . 2002;  4 639-652
• 4 Hester T R, Codner M A, McCord C D, Nahai F. Transorbital lower lid midface rejuvenation.  Oper Tech Plast Reconst Surg . 1998;  5 163-184
• 5 Hamra S T. Periorbital rejuvenation in composite rhytidectomy.  Oper Tech Plast Reconstr Surg . 1998;  5 155-162