Guided suturing technique for midface lift through minimal temporal incision.

[BACKGROUND] The midface has been a difficult zone to manage in rejuvenating surgeries. The major challenge for midface lift is to achieve extensive dissection and elevate the composite tissues en bloc through minimal incisions.

[METHODS] In a total of 22 composite midface lift cases, a titanium cable wire was used. The wire was made into an elastic loop that guided three SMAS-suspending sutures out of the subcutaneous plane through a short incision at the temporal region. Then, each suture was fixated to the deep temporal fascia. Postoperative complications and the subjective assessment of the patients were evaluated.

[RESULTS] Surgeries were successfully commenced in all cases. Midface sagging, eye bags, and nasolabial folds all exhibited considerable improvements. Major complications such as nerve injury and alopecia were not observed. The patients were followed up for an average of 16.9 months. In general, 90% of the patients were satisfied with their outcome.

[CONCLUSION] This guided suspension suturing technique effectuates a more convenient and efficient way to conduct multi-points anchorage of the composite malar flap. When properly executed, this technique allows the anchorage sutures to bite into the deeper layer of the SMAS that ensures firm suspensions in midface rejuvenation surgery.