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James Newman, MD

Arch Facial Plast Surg. 2006;8:245-251.

Objective  To evaluate the safety and efficacy of midface-lifting using an absorbable suspension device (Endotine ST).

Design  Prospective cohort of 10 consecutive adult female patients seen in a private practice who underwent isolated midface-lift without accompanying eyelid surgery or volume augmentation procedures in the setting of an accredited ambulatory surgical center. All patients underwent endoscopic-assisted midface-lifts with general anesthesia or intravenous sedation. Subperiosteal dissections of the midface were performed with fixation of the Endotine ST device to temporalis fascia. Objective and subjective criteria were recorded and photodocumented during the postoperative period at 1 week and 1, 3, and 6 months. Patient characteristics of erythema, tenderness, and pain were recorded with a visual analog scale. The patients and surgeon rated changes from the baseline condition and overall satisfaction with the procedure at 1, 3, and 6 months.

Results  All 10 patients completed the 6-month postoperative follow-up. Nine of the 10 patients had significant improvements in their aesthetic outcome. The most common objective symptom of malar sensitivity diminished significantly between the 1- and 3-month visits. One patient experienced a temporary paresis of the zygomaticofacial nerve that resolved at 3 months. There were no major complications of infection, extrusion, skin irregularities, or device removals.

Conclusions  Midface-lifting with the Endotine ST device provided significant elevation of the malar fat pad with improvement in facial contour. Safety of this surgical technique was comparable to that of midface-lifts in other published studies. Patient acceptance of the midface-lift using the Endotine ST device was favorable. Temporary tenderness over the malar area can be expected during the early postoperative period.

Author Affiliation: Section of Facial Plastic Surgery, Department of Otolaryngology–Head and Neck Surgery, Stanford University Medical Center, Stanford, Calif.

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