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Haffner The temporal endoscopic midface lift

A B C

Figure 15: Before (A) and 6 months after (B and C) temporal endoscopic midface. Note the freshness of the whole face, the diminishing
of the nasolabial folds, more malar fullness, pleasant periorbital of the 55-year-old patient. A proper repositioned midface with more malar
fullness, diminishing of jowling and of the nasojugal folds 6 months after temporal endoscopic midface by a middle aged woman with
happiness and satisfaction

stigma forever. By the MACS lift [10] the lateral face and and sagging are not common by young patients.
the jawline can be well corrected, howewer on the cost Rather a centrofacial depletion is the case by such
of a pretrichal and praearicular scar. The so-called individuals, which is best treated by sharp needle
“third suture” of the midface [10] is also an additive intradermal fat or nano fat or micro fat injections in the
element by the necessity of midface restoration even hands of Verpaele et al. [10] and by the author.
by young individuals. There are many subperiosteal
ways of accesses to the midface to reposition and The rejuvenation effect of the TEM lift is directed
restore it efficient. All of them lack to generate a unity on the centro- and mid- facial sagging tissues and
of the SMAS and also of the skin layer lifting each of therefore adresses the roots of deflation and flattening
them in one block, in one common layer. of the midface by young patients. The reposition of
the malar fat pad in combination with tightening both
In case of a temporal subperiosteal lifting, the of the SMAS and of the skin make a natural volume
fully reposition is partly blocked by the anatomical restoration malar and submalar [Figure 8] and affect
adherence of the SMAS and the facial nerve onto also the jawline [Figures 9-12]. The jaws get the
the zygomatic bone. The anchorage means only a natural and youthful V- form instead of quadratic form
suspensions lift, which does not allow the sunken of jawling after the TEM Lift.
part to merge with the part where the sunken part is
anchored. It is then only the question of believing or So the TEM incorporates the advantages as follows:
not believing, whether any part of the body can be rejuvenation in the problematic centrofacial region,
holded on a cord or “cable” with longevity. volume restoration by reposition, affect also the lateral
jawline and thus without any facial stigma.
The most effectively vertical midface reposition with
direct anchorage is practiced by Botti and Ceravolo, [1] Candidates of the TEM lift are prevented from possible
which was also adopted by the author. Howewer, a complications of a lower lid operation and needs for the
transblepharoplasty vertical, subperiosteal midface centrofacial reposition only one procedure and not three
lift supposes an extended lower lid correction with as like by transblepharoplasty subperiosteal midface
canthopexy, though has many risks of a lower lift. For young patients without severe sagging and
lid correction such as ectropion, scleral show, deflation of the midface and/or without severe jawling
conjunctivitis, chemosis, lagophthalmos, assymetry, and neck problem this scar savin procedure seems to
negative tilt, rounding of the eyes. The procedure be the best choice of by centrofacial rejuvenation by a
needs drilling for bony tunnels, then also skin excision restorative way.
periorbital or temporal, that means three procedures
in the same time: extended lower lid correction plus An additive volume restoration should be however
midface subperiosteal lift plus temporal lift. If a consent an adjuctive part of any rejuvenation of the face,
is correctly made, then such a multiplex combinative than both the ptosis and the volume loss should be
procedure will be mostly refused by a young patient corrected in all parts of the face according to our
and also very rarely can be indicated, than real ptosis conviction.

Plastic and Aesthetic Research ¦ Volume 3 ¦ October 31, 2016 345