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14% of patients dissatisfied with midface rejuvenation surgery
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Fourteen percent of patients who underwent midface rejuvenation surgery were dissatisfied with the results, according to recent study results.
In a retrospective review, researchers studied 150 patients (mean age, 51; 93.3% women) who underwent surgical midface rejuvenation by a single surgeon between 2007 and 2010. Demographics, history, procedures, outcomes and complications were recorded. Previous midface procedures had been conducted on 20.7% of the patients, and 34% underwent multimodalities. Volume loss, midface ptosis, skin elasticity and skeletal anatomy were classified by physical examination and photography results. Follow-up occurred 12 months after procedures, with patient satisfaction determined by midface results. A masked, independent expert analyzed unsatisfactory results.
Procedures included extended lower blepharoplasty with orbital fat transposition (46.7%), endoscopic midface-lift (MFL; 32.7%), deep-plane rhytidectomy (32%), autologous fat grafting (21.3%) and malar implants (2.7%).
Fourteen percent of patients indicated dissatisfaction with results, and the expert agreed in each case. Among those dissatisfied were four of 12 patients (33%) who underwent autologous fat grafting alone, five of 20 patients (25%) who had combined extended lower blepharoplasty and MFL, and one of four patients (25%) for combined endoscopic MFL and autologous fat grafting. Malar hypoplasia (41% vs. 7%; P<.001) or loss of elasticity (16% vs. 3%; P=.01) had significantly higher rates for dissatisfaction, but were not correlated with age (r=0.15).
“Successful midface rejuvenation requires accurate diagnosis and avoidance of anatomic pitfalls,” the researchers concluded. “Dissatisfaction is most common in cases where midfacial aging is accompanied by skeletal insufficiency or severe loss of elasticity. The former group should receive consideration of more frequent use of malar implants, whereas the latter group benefits from a rhytidectomy approach that targets the midface.
“Having the right discussion with the patient and choosing the best rejuvenation plan will help maximize patient satisfaction.”
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