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Pignata et al. Plast Aesthet Res 2018;5:23 I http://dx.doi.org/10.20517/2347-9264.2018.28 Page 5 of 6

Skin removal and fat removal-repositioning techniques can be effectively associated to these procedures
when indicated. Clinical examples in Figures 1 and 2.

CONCLUSIONS
A systematic approach to aesthetic units carries a high satisfaction rate. With the goal of rejuvenating the
periocular region, the authors advocate approaching this area as a unit rather than with individual isolated
techniques that can achieve only limited improvements. MIVEL is a scarless technique that respects the ver-
tical vector of tissue descent. As much as tissue can be lifted, a 3-dimensional rejuvenation of the periocular
aesthetic unit can only be achieved if associated with volume restoration. SEFFI and M-SEFFI techniques as-
sess this issue with a high satisfaction and a low complication rate.

DECLARATIONS
Authors’ contributions
Assistant surgeon in part of the cases, research and writing,: Pignata G
Surgeon in charge of part of the cases: Gennai A
Original idea, surgeon in charge of part of the cases, and processing pictures: Bernardini F

Availability of data and materials
The data were strictly obtained from medical records according to the privacy policy and ethics code of our
institute.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Informed consent was obtained for each procedure and the review adhered to the tenets of the Declaration
of Helsinki.

Consent for publication
Informed consent was obtained for publication.

Copyright
© The Author(s) 2018.

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