FIELD: medicine; plastic surgery.
SUBSTANCE: cut flaps of the superficial muscular aponeurotic system of the face are mobilized, moved, and refixed, excess skin is excised in the lower third of the face and neck, and the skin is sutured. When lifting the lower thirds of the face and neck, the upper two thirds of the face are simultaneously endoscopically tightened. The upper facial flap is fixed with intraosseous removable screws to the frontal part of the cranial vault. Then upper and lower blepharoplasty is performed to remove the hernia of the upper eyelids. Through an access along the mucous membrane of the oral vestibule 2 cm long, mobilization and transposition of the fatty bodies of the cheeks are performed, they are sutured twice and cable sutures are applied, fixing them to the superficial layers of the deep temporal fascia. Through an access in the submental area at a distance of 2–3 cm from the anterior edge of the mental protuberance, 4–5 cm long, a subperiosteal dissection of the mental protuberance of the lower jaw is performed, a chin implant is installed to the mental protuberance of the mandible, and the implant is fixed with 4 titanium mini-screws. Under visual control of the endoscope, the lateral canthal ligament is fixed with cable sutures to the superficial layer of the deep temporal fascia using PDS 4-0 thread, the sutures are applied in the cranial and lateral directions, at an angle of 35°.
EFFECT: method makes it possible to eliminate the formation of excess skin at the border between the middle and lower third of the face in the form of arched folds of skin, due to the simultaneous performance of endoscopic lifting of the middle and upper third of the face, to move the excess volume of soft tissue from the lower third of the face to the area of the middle third of the face and obtain a more pronounced rejuvenating effect by performing mobilization and transposition of the fatty bodies of the cheeks using cable sutures, increasing the projection of the mental protuberance of the lower jaw and visually increasing the severity of the cervical-mental angle due to the installation of a chin implant, changing the negative intercanthal tilt to positive and eliminating the possibility of developing dry eye syndrome by performing endoscopic canthopexy.
1 cl, 32 dwg, 2 ex
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Authors
Dates
2024-05-15—Published
2023-03-29—Filed