Safety and Effectiveness, 7 × 2 Surgical Technique, for the Partial Elevation of the Upper Facial Third

A partial upper third facial lift technique is described, using measurements of 7 cm (2.75591 in) length by 2 cm (0.787402 in) in an arch-shaped temporal approach for lifting, examining its safety and effectiveness. The retrospective study includes 458 patients who requested partial temporal facelifts. Since the study was retrospective, approval from an ethics committee was not required.

Introduction

We began a surgical adventure in 1984 with a technique against aging and sagging of the temporo-orbital region and the tail of the eyebrows. When I realized the amount of tissue that was removed in the full-face approach in the temporal region, We began to perform arc-shaped resections in the scalp of 7 × 2 cm in the orbit temporal region as an easily reproducible, simple, and safe method and as the only technique in patients who due to their appearance or age did not require a full-face lift. The upper face, including the eyebrows and areas around the eyes, plays an active role in facial aging [1].

Currently, there are numerous methods and techniques available for upper face lift surgery, but these methods involve tissue separation, plication, the superficial Musculo-aponeurotic system, or the skin-SMAS complex [2].

However, these facelift procedures are invasive and complex and require a long recovery period [3], [4].

Materials and Methods

The use of a temporary approach technique for partial elevation of the upper third of the face with measurements of 7 × 2 cm to lift ptotic areas of the upper third of the face is a good alternative to more invasive procedures [5].

The temporary 7 × 2 intervention method has positive results with reduced scarring, rapid recovery and few complications. It can be used in cases of male pattern baldness up to Norwood category VI, since the incision is easily hidden by the hair. With the temporary 7 × 2 technique you can reduce or eliminate the amount of skin removed from the upper eyelid, especially in secondary surgical interventions in this area.

Surgical Technique

Start the 7 × 2 method with a subperiosteal detachment followed by no subcutaneous detachment, at the end, no benefits are observed at any other level of separation other than without subcutaneous detachment.

It is performed under general anesthesia or local anesthesia; the latter being preferred as it minimizes risks for patients. Once the surgical area is prepared, the approach sites are located for the 7 cm (2.75591 in) long by 2 cm (0.787402 in) wide layout to be incised in the temporal region bilaterally (Figs. 1 and 2). An infiltration of the anesthetic, 2% lidocaine with epinephrine, is performed. An infiltration of 5 cc is performed in each temporal region. The anterior and front posterior of hair is secured with rubber bands [6].

Fig. 1. The approach sites are located 2 cm wide.

Fig. 2. By 7 cm long.

The incision in the hair begins at the root of the helix at the tangent end of the lateral edge, the extension of the incision is 7 cm long by 2 cm wide, parallel to the hair follicles to prevent alopecia in the postoperative period.

Once the incision is made in the temporal region, the removal of the scalp begins at the level of the ear and on the musculoaponeurotic plane that contains the frontal branch of the facial nerve (Fig. 3). The superficial temporal artery can usually be isolated and left as a pedicle. There is usually little bleeding.

Fig. 3. Scalp excision.

Any other vessels are ligated. The scalp and subcutaneous tissue are excised, without detaching the adjacent areas. A simple 3-zero Nylon suture is applied to approach the edges and begin closure.

Closure is completed with surgical staples. The same technique is performed on the contralateral side (Fig. 4).

Fig. 4. Closure is performed with staples.

The dimensions of the arc-shaped incision of 7 cm × 2 cm were found to be applicable to most patients. Figs. 5–8 demonstrate a variety of clinical cases.

Fig. 5. The 7 × 2 technique before and after and the result 18 years later.

Fig. 6. Only 7 × 2 technique.

Fig. 7. 7 × 2 technique and blepharoplasty.

Fig. 8. 7 × 2 technique, blepharoplasty and bichat bags.

Conclusion

All 458 patients had complete recovery without serious complications. The patient satisfaction rate was 93%. 19% were men and 81% were women, between the ages of 35 and 72. The most frequent complication was transient edema, which resolved rapidly, with some cases of temporary alopecia that were not significant for complete recovery. Long-term data from a cohort of 458 patients demonstrate that the 7 × 2 Upper Face Lift Surgical Technique is a safe, effective, reproducible technique for upper face lift rejuvenation. This method represents a unique strategy for an upper face lift by which consistently excellent results can be achieved [7], [8].