Vertical Space Lift: Transcutaneous Lower Blepharoplasty, Subperiosteal Midface Lift, and Lower Face Lift: A Novel Technique of Buccal Fat Suspension to Medial Infraorbital Rim

BACKGROUND: Despite traditional facelift and transtemporal endoscopic facelift techniques are used in treatment of mid face ptosis, they do not have a big impact on the midface area. Lower blepharoplasty techniques are effective to provide rejuvenation on nasojugal area, midface ptosis and tear trough deformity. Additionally, it is also possible to correct the lower face area and jowls with lower blepharoplasty. OBJECTIVES: To define effect of vertical space lift in tear-trough, midcheek groove, midface, and lower face. METHODS: A retrospective study was carried out on 23 patients who had surgeries between January 2018 and January 2021. The buccal fat is suspended and anchored to the medial infra orbital rim with a superomedial vector and the midface flap anchored to the lower and lateral orbital rim with a superomedial and superolateral vector. The average follow-up period was 12 months. RESULTS: A high degree of satisfaction has been achieved in the feedback of questionnaires. Results showed that there is a significant improvement in nasojugal deformity, malar ptosis, mid-cheek grove, and jowls. CONCLUSIONS: While transcutaneous lower blepharoplasty provides an opportunity for rejuvenation of the lower eyelid and midface area, vertical space lift allows the surgeon to work on the midface, lower face, and jowls area except the neck. Choosing appropriate technique according to area that needs to be corrected increases success rate. LEVEL OF EVIDENCE: 4: [Image: see text]