Objectives: How to improve the results achieved through Face lift procedures. What should be done to acheive a comprehensive harmonious facial rejuvenation

Introduction: Historically, Facial rejuvenation procedures were synonymous with Face lift. Face lift only focused on lifting and tightening. Every modification or improvisation was towards making the Face lift/ Rhytidoplasty procedure more extensive and complex. This paper analyses facial ageing over various decades and pinpoints the pathophysiologic changes. Volume loss is an important change, and it has not been addressed adequately in previous techniques. A technique is demonstrated and its results analysed to see if the changes are adequately reversed.

Materials / method: An operative video of Extended high SMAS facelift is demonstrated with micro fat grafting. Results from this procedure have been analysed to see if the volume loss is adequately addressed.

Results: 80-100% satisfaction was recorded following this procedure. Various case scenarios have been presented.

Conclusion: Volume loss is an important change along with sagging and thinning of the skin. Traditional facelift lifts the sagging skin adequately. However, the technique presented shows how to achieve repositioning of fat to give volumisation. It also shows where fat grafting complements this procedure and should be considered.

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Objectives: The concept of malar reduction in Oriental
Minimal invasive method of zygomatic reduction

Introduction: Malar reduction is among the most solicited aesthetic procedures performed in Asia. An increasing number of patients seek a subtle change to their zygomatic contour, with short downtime and minimal invasion for an ideal slim oval youthful face.

Materials / method: Through a small intraoral incision combined with an external small incision in the hair-bearing temporal scalp and with endoscopic assistance, a safe and effective technique is described for malar reduction and repositioning for aesthetic midface improvement.

Results: Twenty-three subjects underwent our technique of malarplasty and were followed up for a mean 12.3 months; none had such complications as facial paresis, hematoma, postoperative asymmetry needing re-operation, sinusitis, and temporomandibular joint problems. Mean downtime was 3 days and most returned to work within 7 days once edema subsided. None developed cheek ptosis or bony nonunion and all were satisfied with their appearance.

Conclusion: Using our prescribed approach, desired predictable malar reduction outcomes can be achieved through a minimally invasive procedure that allows precise complete control of the osteotomies and final zygoma positioning, minimizes risk of complications, and incorporates all the benefits of an intraoral-cum-external-endoscopic approach with unparalleled visualization.

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