Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.
Semin Plast Surg. 2009 Nov;23(4):274-82. doi: 10.1055/s-0029-1242182.
The endoscopic midface lift procedure has evolved from experience with postreduction soft tissue repair after facial fracture fixation. The procedure elevates and repositions midface soft tissue, which descends with facial aging; as well, it can correct periorbital congenital abnormalities, such as exorbitism and lateral canthal displacement. The procedure has been refined by the senior author to employ a temporal endoscopic approach alleviating the need for a lower eyelid incision. The plane is sub-SMAS (superficial muscular aponeurotic system) within the pre-zygomatic space with release of the zygo-orbicular ligament and the malar retaining ligament. Using an endoscopically placed suture in the malar retaining ligament, the midface and orbicularis oculi are elevated en bloc, with additional selective sutures applied for specific lower eyelid and cheek morphology. Ancillary lower eyelid procedures including skin resurfacing, skin excision, soft tissue augmentation, and a transblepharoplasty septal reset can all be safely applied to the lower eyelid in the same operative setting. All procedures are technically advanced though once executed deliver an exact correction of the midface, which can be combined with both brow and lower face rejuvenation. The procedure offers limited recovery time and few complications as the facial surgeon becomes facile with the technique.
内镜中面部提升术源于面部骨折固定后软组织修复的经验。该手术提升和重新定位中面部软组织，随着面部衰老，软组织会下垂；此外，它还可以矫正眶周先天性异常，如眼球突出和外眦移位。该手术由资深作者进行了改进，采用了颞部内镜入路，减轻了对下眼睑切口的需求。手术平面在颧前间隙的 SMAS 下（浅表肌肉筋膜系统），释放颧眶韧带和颧骨颧肌韧带。通过在颧骨颧肌韧带上放置内镜缝线，整块提升中面部和眼轮匝肌，此外还针对特定的下眼睑和脸颊形态应用选择性缝线。辅助下眼睑手术，包括皮肤磨皮、皮肤切除、软组织填充和经睑内眦隔重置术，都可以在同一手术环境中安全应用于下眼睑。所有手术都具有较高的技术难度，但一旦执行，就能精确矫正中面部，可与眉部和下面部年轻化联合进行。随着面部外科医生对该技术的熟练掌握，该手术恢复期短，并发症少。
