Midface Rejuvenation: Evaluation of Surgical and Non-Surgical Techniques

Background: Facial aging reflects the effects of time, intrinsic and extrinsic factors on the skin, soft tissues, and deep structural components of the face, and is a complex synergy of skin textural changes and loss of facial volume. The facial manifestations of aging reflect the combined effects of gravity, progressive bone resorption, decreased tissue elasticity, and redistribution of subcutaneous fullness. Methods: In this study, we are aiming at evaluating different techniques of midface rejuvenation, both surgical and non-surgical. In addition, we discuss how to choose the most suitable approach, according to each individual case, to achieve more natural and lasting results. A total of 21 patients were included in this study, ages from 40 to 66 years. •Group A: Consisted of patients undergoing a surgical procedure for midface-lifting (7 patients). •Group B: Consisted of patients undergoing a non-surgical procedure for midface rejuvenation (7 patients). •Group C: Consisted of patients undergoing a combined procedure of surgical and non-surgical techniques (7 patients). As for the surgical procedure, we introduce two innovations for midface lift, through suspending the elevated midface soft tissue to: 1-Infra orbital margin by biodegradable screws. 2-Peri-ostium of infro lateral orbital rim (canthopexy is mandatory). Discussion: As the facial rejuvenation is an elective procedure, the questions of the cost, the post-procedural convalescence, the common risks and complications, as well as the achievability of the patient’s desires and expectations, are among the leading factors determining which technique will be implied on the patient. In our study, we focused on these four aspects to come to a conclusion of the pros and cons of each procedure. In addition, our innovative surgical techniques (1) Have less risk of frontal nerve injury (2) Give better cheek appearance (3) Open the nasolabial folds more perfectly and (4) Avoid ectropion and sagging oflower eyelid. All these can be done under local anesthesia. Conclusion: No specific technique may be referred to as “the best” when addressing the facial aging. The plastic surgeon should decide the best procedure(s) for each patient individually. Therefore, selection of the method of cosmetic intervention (surgical or non-surgical or combined approach) must be based on an examination of the patient and an analysis of the face in its entirety (i.e.: The forehead area, the brows and eyelids, cheeks and mid face region, and lower face and neck). Nevertheless, we attribute the previously mentioned advantages to our innovative surgical technique.