Face lift with reposition malarplasty.

BACKGROUND: The malar highlight should be considered when performing face lifts in the midface area to restore young and attractive facial contour. The young, attractive face has malar highlights in the superior portion and a malar fat pad that provides fullness in the zygomatic area. Actually effective facial rejuvenation cannot be achieved by simply tightening soft tissue, especially in patients with a wide and descending mala. Furthermore, in patients with wide faces and a strong malar eminence, a face lift alone tends to make the face look wider. Therefore, the authors combined face lift with repositioning malarplasty to change the facial skeleton.

METHODS: From March of 1989 to February of 2005, the authors performed malar repositioning to a more attractive position (usually superiorly and medially) and a simultaneous subperiosteal midface lift and forehead lift in 96 patients with aging faces and prominent, wide malar complexes. The subcutaneous face lift with superficial musculoaponeurotic system procedure has been added as a standard procedure for patients with lower face and neck problems.

RESULTS: Postoperatively, malar highlights were moved to a more attractive position, and all patients were satisfied with their results. No serious complications, such as facial nerve injury or flap necrosis, were reported.

CONCLUSION: Reposition malarplasty and face lift in combination proved to be an effective, long-lasting, and satisfactory method of facial rejuvenation, especially in patients with wide faces and a strong malar eminence.