Mask lift and facial aesthetic sculpturing.

Paul Tessier started the great adventure of sculpturing the malformed face more than 30 years ago. Key procedures such as subperiosteal dissection and lifting of the facial mask, bone grafting from a cranial site of harvest, and lateral canthopexies have been utilized and have withstood the trial of time in thousands of patients. The mask lift with facial aesthetic sculpturing, a newcomer in aesthetic surgery, is an extrapolation of these craniofacial procedures. It is a different and revolutionary approach to the aging face that seeks to normalize, rejuvenate, and embellish the face through a subperiosteal lift of the facial mask and transformation of the underlying structures. Facial aesthetic sculpturing refers to the aesthetic sculpturing of the facial skeleton. It allows us to equilibrate the components of a malformed face and normalize it by osteotomies, displacements in three dimensions, and bone overgrafting; to normalize the forms of an unattractive face and to embellish it by harmonization of the skeletal volume; and to restore the forms of an aging face and to rejuvenate it by augmenting resorbed bone, reducing hypertrophic bone, and lifting the facial mask. My experience includes 350 patients operated on from 1981 to 1992, of these, 200 cases were purely aesthetic, 150 functional. The complications encountered have been few. The technique described offers an appropriate response to the different problems of aging and embellishment of a face, whether for reequilibration of osseous volumes or for sagging of soft tissues of the superior two-thirds of the face. Facial aesthetic sculpturing finds application also in some malformations and acquired deformities and in young faces with unsightly features.