A quantitative analysis of lateral canthal position following endoscopic forehead-midface-lift surgery.

IMPORTANCE The value of this study is to evaluate outcomes of endoscopic forehead-midface-lift surgery. Many surgeons are reluctant to offer this procedure for fear of change in the shape and appearance of the eyelid. OBJECTIVE To objectively evaluate the change in lateral canthal position following endoscopic forehead-midface-lift surgery. DESIGN A retrospective review of consecutive patients undergoing endoscopic forehead-midface-lift and lower blepharoplasty procedures for cosmetic midface rejuvenation. SETTING A private facial plastic surgery practice. PARTICIPANTS Photometric data were obtained from before-and-after surgery images from 40 patients. MAIN OUTCOMES AND MEASURES All photographs were analyzed to determine the horizontal width, vertical height, palpebral fissure width, or angle between the medial and lateral canthi. The right and left eyes were evaluated independently, with the results analyzed using a 2-tailed paired t test with a confidence interval of 0.05 or less (required for statistical significance). RESULTS The results indicated no statistically significant change in the horizontal width (right, P = .25; left P = .07), vertical height (right, P = .99; left, P = .72), palpebral fissure width (right, P = .28; left, P = .48), and angle of the lateral canthus (right, P = .99; left, P = .30) before and after surgery. CONCLUSIONS AND RELEVANCE The endoscopic forehead-midface-lift is a reliable method of addressing midface descent. This study objectively identified no significant differences in the position of the lateral canthus before and after surgery. LEVEL OF EVIDENCE 4.