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Surgical Anatomy of Midface Lift
Gaby Doumit,Bahar Bassiri Gharb,Francis Papay, James Zins
2014-03-09
Presenter: Gaby Doumit
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Presentation Category: Basic Science ResearchAbstract Category: Craniomaxillofacial
Purpose-This study assesses the position of the buccal branches of the facial nerve (BBFN) and the course of the ION in the supraperiosteal plane relevant to subperiosteal transconjuntival midface lift.
Methods-Fourteen hemi-facial dissections were performed through a preauricular incision. The BBFN were marked on the facial skeleton as they entered under the lateral border of the zygomatic major muscle. Midface dissection was carried through a transconjunctival and upper gingival-buccal sulcus incision. The location of the BBFN was documented in relation to the caudal border of the zygomatic-maxillary (ZM) suture. The ION was identified and its branches were dissected in the supraperiosteal plane until they passed superficially into the facial soft tissue.
Results-On average there were 3 branches of the facial nerve innervating the zygomatic major muscle and 1.8 branches entering the muscle superior to the caudal border of the ZM suture. The most superior buccal branch of the facial nerve was found to lie at a mean of 6.8 mm superior to the inferior border of the ZM suture and at 1 mm elevation from the bone. The most inferior branch was at a mean of 7.2 mm inferior to the caudal border of ZM suture. On average the ION had 5.2 fascicles. They traveled for an average distance of 10.2 mm above the periosteum before they passed into a superficial plane.
Conclusions-The surgeon must be aware of the facial and infraorbital nerves anatomy during release of the upper masseteric ligaments and placement of the periosteal suspension sutures.
