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Haffner The temporal endoscopic midface lift

is administered. We have not observed any pain or
other complications during the last 15 years using this
simple and effective method, which can be applied to
more extensive open face and midface lifts.

Bandaging
We apply elastic bandaging to the head for the first
two postoperative days. Then we use kinesio tapes for
the stabilization of the operation results during the first
week, similar to that used by athletes for sport injuries.
These tapes promote healing by preserving the lift as
well as improving the dynamic lymphatic drainage.
Figure 7: The skin adapts itself without tension after removal of the This thereby contributes to a quicker reduction in
excess skin swelling. Conventional dressings may be omitted after
the second day.

RESULTS

The lifting effect of the temporal endoscopic midface
lift extends from the eyebrows to the midface, and
affects also the jawline and neck [Figures 9-13].
The operation is relatively quick and takes two and
a half to three hours in the hands of an experienced
endoscopic surgeon. The postoperative results appear
very natural and do not suffer from an “operated” look.
The author attributes this to lifting using the correct
vector against the force of gravity. The healing period
takes approximately 14 days, and largely dependent
on the variable resolution of oedema and swollen
eyes. We stress that overcorrection is very important,
which requires a calculated distortion. This distortion
that is similar in appearance to “almond eyes” or
“cat eyes” may persist for two to four weeks prior to
Figure 8: Demonstrating the efficiency of temporal endoscopic resolution.
midface by an intraoperative shot after completing of the left side.
Fully reposition and anchoring of flat malar tissues and the sagging
jowls on the left side. Note that the operation takes place under full There are no facelift stigmas or conspicuous scars on
local anesthesia, an anaesthesiologist is not present during our the face. The only scar is located within the temporal
facelift. The patient can feel and can also give a response in cases,
if the operateur works nearby to the nerves. The patient can help the
surgeon to prevent nerve injuries
A B
After excising the excess skin, the skin adapts itself
well and can be closed tension-free with USP 5-0
interrupted sutures.

Anaesthesia for TEM lift
Facial procedures are performed in the authors
practice with a combination of sedation and local
anaesthesia [Figure 8]. Approximately 100-200 mL
of Klein’s tumescence solution is used for local
anaesthesia. The solution is made up with the
following components: 500 mL 0.9% NaCl, 50 mL of
2% Lidocaine, 1 mL of 1 mg/mL epinephrine 4 from
Adrenalin®. A dose of 5 mg Midazolam is given as pre-
medication. Patients also receive 3-5 mg of Piritramide Figure 9: Before (A) and 6 months after temporal endoscopic midface
(B). More pleasant looking after endoscopic midface reposition by
intravenously before the local anaesthesia infiltration diminishing the suborbicular hollowing
Plastic and Aesthetic Research ¦ Volume 3 ¦ October 31, 2016 343