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de la Torre et al. Plast Aesthet Res 2020;7:11 Plastic and
DOI: 10.20517/2347-9264.2019.54 Aesthetic Research

Original Article Open Access

A minimally invasive midface suspension

Jorge I. de la Torre, John Lindsey Jr., Dean Cerio, Luis O. Vasconez

Division of Plastic Surgery, University of Alabama at Birmingham and Birmingham V.A. Medical Center Birmingham, Birmingham, AL
35294, USA.

Correspondence to: Dr. Jorge I. de la Torre, MD, MSHA, UAB Plastic Surgery, 500 22nd Street, South - JWB 103 Birmingham,
Birmingham, AL 35294, USA. E-mail: jdlt@uab.edu
How to cite this article: de la Torre JI, Lindsey Jr. J, Cerio D, Vasconez LO. A minimally invasive midface suspension. Plast Aesthet Res
2020;7:11. http://dx.doi.org/10.20517/2347-9264.2019.54
Received: 8 Nov 2019 First Decision: 13 Jan 2020 Revised: 10 Feb 2020 Accepted: 20 Feb 2020 Published: 13 Mar 2020

Science Editor: John Yousif Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract

Aim: With the normal aging process, the malar fat pad descends vertically, causing a number of characteristic changes
to the face. Various techniques have been used to correct ptosis of the malar fat pad.

Methods: The authors describe a technique that is minimally invasive and can be used to correct malar fat pad ptosis.
This technique uses a suspension suture to elevate the malar fat pad to a more youthful position. The technique has been
successfully used in 71 patients.

Results: All of the cases were performed in the office setting under local anesthesia. There were no complications, and,
by patient self-report and physician exam, results have been lasting and satisfactory.

Conclusion: The minimally invasive midface suspension is a safe and successful approach to midface rejuvenation in
properly selected patients.
Keywords: Midface rejuvenation, midface suspension, malar fat pad, facial rejuvenation

INTRODUCTION
The malar fat pad is a critical component of the midface and its descent impacts several aspects of facial
aging. It is a fibro-fatty triangular structure that is just below the dermis and subcutaneous tissue. It is
[1]
superficial to the superficial muscular aponeurotic system (SMAS) . This triangular structure has its apex
located at the oral commissure; the lateral border is a line from the apex to the lateral canthus; the medial
border is a line from the apex to the medial canthus; and the superior border is a horizontal line that runs
[2]
along the inferior aspect of the lower eye .
© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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and indicate if changes were made.

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