Abstract
The objective was to review our favorable experience in the use of prophylactic midface
lifts in the setting of severe midfacial trauma. A retrospective review of a consecutive
series of patients undergoing prophylactic midface lifts at the time of definitive
fracture repair in a County Hospital Level 1 trauma center was done. All patients
undergoing midface lifts at the time of fracture repair by the senior author from
July 1998 to July 2012 were included in this review. A total of 72 patients (58 males,
14 females, average age: 36.2 years) were available for review. Sixty-three patients
had a minimal follow-up of at least 3 months. No complications felt to be related
to the midfacial suspension were noted. There were no instances of frontal nerve paralysis
or palsy. There were no patients with ectropion. Patient midfacial symmetry was evaluated
by two blinded facial plastic surgeons. It was felt to be excellent in 53 patients,
good in 9, fair in 1, and poor in none. The force of trauma necessary to elicit a
severe midfacial fracture and the subsequent subperiosteal dissection required to
expose the fractures for rigid fixation result in severe laxity of the midfacial soft
tissue envelope. Failure to suspend and support these soft tissues will result in
significant facial asymmetry. Prophylactic endoscopic midface suspension appears to
be a safe and effective method of largely eliminating this problem and should be considered
in the setting of severe midfacial fractures.
Keywords
midface lift - maxilla fractures - facial trauma - facial deformity - endoscopic surgery
