The author describes how anatomic findings and the differing goals of male and female patients, as well as other considerations, have altered his technique for surgical correction of the aging midface. (Aesthetic Surg J 2001;21:349-353.).

OBJECTIVE To present the authors' experience and outcomes in the reconstruction of midfacial defects using cervicofacial advancement-rotation flaps (CARFs) based on a method of determining forward or reverse design in relation to the proportions of the defect. STUDY DESIGN Case series with retrospective chart review. SETTING Tertiary care academic medical center. SUBJECTS AND METHODS Pati...

OBJECTIVE To evaluate the aesthetic results in our initial group of patients treated with a combination of a midface-lift and fat transfer compared with a randomly selected group of patients who underwent a midface-lift without concurrent fat transfer by one of us. METHODS The setting was a private, ambulatory, surgical center. The design was a comparative study between patients who did or di...

The aging midface has long been overlooked in cosmetic surgery. Our understanding of facial aging in terms of 3 dimensions has placed increased importance on volume restoration. Although an "off-label" indication for most fillers in this facial region, volumization of the midface with injectable fillers is usually a safe and straightforward procedure technically. Injectors, nevertheless, need t...

Sculptra (poly-L-lactic acid), a new injectable soft tissue filler designed to stimulate neocollagenesis, increase dermal thickness, and enhance volume, is most commonly used for the midface and temporal fossa, with more limited use in the mental and prejowl areas. In the authors' practice, Sculptra injections have virtually replaced autologous fat transfer, yielding excellent results for patie...

Recession of the midface is a relatively common condition that can have a negative impact on facial and nasal aesthetic appearance, and it poses a challenge to plastic surgeons. In cases with generalized maxillary retrusion and/or malocclusion, bone advancement surgery is required, but in localized cases, mostly seen in cleft lip patients, the quest is for an ideal material and a proper techniq...

Age is the most significant factor contributing to the overall change in the appearance of an individual's facial features over time. This gradual process of structural weakening of the face begins during the third decade and continues to worsen during the remainder of an individual's lifetime. In this article we discuss how the approach to midface rejuvenation has evolved over time owing to ou...

The medical records of 437 patients with 929 facial fractures were retrospectively analyzed. Fracture patterns were classified based on the presence or absence of fractures in each of 4 anatomic subunits (frontal, upper midface, lower midface, and mandible). The most common etiology of trauma was assault (36%), followed by motor vehicle collision (MVC, 32%), fall (18%), sports (11%), occupation...

BACKGROUND Innervated free muscle transfer using the gracilis muscle or temporalis myoplasty has been successfully utilized for facial reanimation in chronic facial palsy. These techniques are less suited to immediate facial reconstruction in the setting of radical parotidectomy, in which the complexity of the defect, patient age, postoperative radiotherapy, and limited life expectancy pose par...