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Subperiosteal Rhytidectomy Workup

  • Author: Adam J Cohen, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
 
Updated: Nov 17, 2015
 

Laboratory Studies

Preoperative complete blood counts, coagulation profiles, and chemistries should be obtained.

An ECG and chest roentgenogram may be indicated for review by the appropriate specialist preoperatively.

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Imaging Studies

Standard preoperative photos are useful for intraoperative reference and reminding the patient of his or her presurgical appearance when critiquing the outcome.

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Contributor Information and Disclosures
Author

Adam J Cohen, MD Assistant Professor of Ophthalmology, Section Director of Oculoplastic and Reconstructive Surgery, Rush Medical College of Rush University Medical Center

Adam J Cohen, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Ophthalmic Plastic and Reconstructive Surgery, American College of Surgeons

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: BioD, Poferious<br/>Serve(d) as a speaker or a member of a speakers bureau for: IOP<br/>Received income in an amount equal to or greater than $250 from: IOP for speaking.

Coauthor(s)

Michael Mercandetti, MD, MBA, FACS Private Practice

Michael Mercandetti, MD, MBA, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, Sarasota County Medical Society, American Academy of Ophthalmology, American College of Surgeons, American Society for Laser Medicine and Surgery, American Society of Ophthalmic Plastic and Reconstructive Surgery, Association of Military Surgeons of the US

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Dominique Dorion, MD, MSc, FRCSC, FACS Deputy Dean and Associate Dean of Resources, Professor of Surgery, Division of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Université de Sherbrooke, Canada

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;RxRevu;SymbiaAllergySolutions<br/>Received income in an amount equal to or greater than $250 from: Symbia<br/>Received from Allergy Solutions, Inc for board membership; Received honoraria from RxRevu for chief medical editor; Received salary from Medvoy for founder and president; Received consulting fee from Corvectra for senior medical advisor; Received ownership interest from Cerescan for consulting; Received consulting fee from Essiahealth for advisor; Received consulting fee from Carespan for advisor; Received consulting fee from Covidien for consulting.

Additional Contributors

Anthony P Sclafani, MD Director of Facial Plastic Surgery and Surgeon Director, New York Eye and Ear Infirmary of Mt Sinai; Professor of Otolaryngology, Icahn School of Medicine at Mt Sinai

Anthony P Sclafani, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons

Disclosure: Received salary from Aesthetic Factors, Inc. for consulting; Received consulting fee from Meditech Medical Enterprises for independent contractor; Received royalty from Thieme Medical Publishers for author; Received royalty from Jaypee Medical Publishers for author.

References
  1. Tessier P. [Subperiosteal face-lift]. Ann Chir Plast Esthet. 1989. 34(3):193-7. [Medline].

  2. Psillakis JM, Rumley TO, Camargos A. Subperiosteal approach as an improved concept for correction of the aging face. Plast Reconstr Surg. 1988 Sep. 82(3):383-94. [Medline].

  3. Ramirez OM, Pozner JN. Subperiosteal minimally invasive laser endoscopic rhytidectomy: the SMILE facelift. Aesthetic Plast Surg. 1996 Nov-Dec. 20(6):463-70. [Medline].

  4. Ramirez OM. High-tech facelift. Aesthetic Plast Surg. 1998 Sep-Oct. 22(5):318-28. [Medline].

  5. Hamra ST. The deep-plane rhytidectomy. Plast Reconstr Surg. 1990 Jul. 86(1):53-61; discussion 62-3. [Medline].

  6. American Society for Aesthetic Plastic Surgery. Despite Recession, Overall Plastic Surgery Demand Drops Only 2 Percent From Last Year. American Society for Aesthetic Plastic Surgery. Available at http://www.surgery.org/media/news-releases/despite-recession-overall-plastic-surgery-demand-drops-only-2-percent-from-last-year. Accessed: 3/18/2010.

  7. Furnas DW. The retaining ligaments of the cheek. Plast Reconstr Surg. 1989 Jan. 83(1):11-6. [Medline].

  8. Heinrichs HL, Kaidi AA. Subperiosteal face lift: a 200-case, 4-year review. Plast Reconstr Surg. 1998 Sep. 102(3):843-55. [Medline].

  9. Quatela VC, Sabini-P. Techniques in deep plane facelifting. Facial Plast Surg Clin North Am. May 2000. 8(2):193-209.

  10. Stuzin JM, Baker TJ, Gordon HL, et al. Extended SMAS dissection as an approach to midface rejuvenation. Clin Plast Surg. 1995 Apr. 22(2):295-311. [Medline].

  11. Toth BA, Daane SP. Subperiosteal midface lifting: a simplified approach. Ann Plast Surg. 2004 Mar. 52(3):293-6. [Medline].

  12. Patrocinio LG, Patrocinio JA, Couto HG, et al. Subperiosteal facelift: a 5-year experience. Braz J Otorhinolaryngol. 2006 Sep-Oct. 72(5):592-7. [Medline].

  13. Gentile RD. Subperiosteal deep plane rhytidectomy: the composite midface lift. Facial Plast Surg. 2005 Nov. 21(4):286-95. [Medline].

  14. Hönig JF, Knutti D, Hasse FM. Centro-lateral subperiosteal vertical midface lift. GMS Interdiscip Plast Reconstr Surg DGPW. 2014. 3:Doc04. [Medline]. [Full Text].

  15. Sclafani AP. Comprehensive periorbital rejuvenation with resorbable endotine implants for trans-lid brow and midface elevation. Facial Plast Surg Clin North Am. 2007 May. 15(2):255-64, viii. [Medline].

  16. Newman J. Safety and efficacy of midface-lifts with an absorbable soft tissue suspension device. Arch Facial Plast Surg. 2006 Jul-Aug. 8(4):245-51. [Medline].

  17. Jones BM, Lo SJ. The impact of endoscopic brow lift on eyebrow morphology, aesthetics, and longevity: objective and subjective measurements over a 5-year period. Plast Reconstr Surg. 2013 Aug. 132 (2):226e-238e. [Medline].

  18. Cheng ET, Perkins SW. Rhytidectomy analysis: twenty years of experience. Facial Plast Surg Clin North Am. 2005 Feb. 13(1):15-31. [Medline].

  19. Guyuron B, Watkins F, Totonchi A. Modified temporal incision for facial rhytidectomy: an 18-year experience. Plast Reconstr Surg. 2005 Feb. 115(2):609-16; discussion 617-9. [Medline].

  20. Mercandetti M, Cohen AJ. Anesthesia, Local With Sedation. Medscape Reference Journal. [Full Text].

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When an endoscopic forehead lift is done in conjunction with a facelift, the lateral port can be used as an access site for a midface lift as shown here.
A cheek flap is developed in preparation for a deep plane dissection.
The superficial muscular and aponeurotic system (SMAS) is incised to facilitate a deep plane dissection.
The superficial muscular and aponeurotic system (SMAS) is imbricated and secured in a more superior posterior position with sutures.
Creation of partial thickness Endotine hole for placement of device.
Subperiosteal midface dissection via a transconjunctival approach.
 
 
 
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