Handchir Mikrochir Plast Chir 2014; 46(04): 224-233
DOI: 10.1055/s-0034-1385927
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Midface Lift: Our Current Approaches

Verjüngung des Mittelgesichts: Aktuelle Ansätze
G. Botti
1   Plastic Surgery, Villa Bella Clinic, Saló, Italy
C. Botti
1   Plastic Surgery, Villa Bella Clinic, Saló, Italy
› Author Affiliations
Further Information

Publication History

received 23 July 2014

accepted 23 July 2014

Publication Date:
27 August 2014 (online)


In the last few years, surgery of the ageing face seems to have shifted from tissue uplifting and tightening to mere filling. We do not agree with this trend. We are positive that ageing brings about 2 basic phenomena: on one hand bone and fat volume reduction, whilst on the other a deterioration of the skin lining (elastosis) leading to an increase in its compliance and extension. We therefore deem of the utmost importance to couple soft tissue filling with indispensable tightening and repositioning together with resection of overabundant skin. For what concerns the mid-face area in particular, we suggest to resort to 3 different lifting techniques, according to the kind of defect to be treated. It is important to take the right pulling vector into consideration as well as the need of skin excess removal. The procedures can be tailored to suit any peculiar need such as malar bag, lower lid border malposition, tear trough deformity, etc. Different cases will be taken into consideration as examples of the various indications and techniques.


In der Chirurgie des alternden Gesichts wurde in den letzten Jahren zunehmend statt Gewebeanhebung und Gewebestraffung lediglich die Gewebeunterspritzung durchgeführt. Die Autoren unterstützen diesen Trend nicht. Wir sind vielmehr der Ansicht, dass Alterung 2 grundlegende Phänomene mit sich bringt: einerseits eine Reduktion des Knochen- und Fettvolumens, andererseits eine Verschlechterung des elastischen Eigenschaften der Haut, was zu höherer Dehnbarkeit und Dehnung führt. Wir sind daher überzeugt, dass die Unterspritzung von Weichgewebe im Gesicht generell mit der dafür erforderlichen Straffung und Neupositionierung mit einer Resektion der überschüssigen Haut gekoppelt werden sollte. Insbesondere in Bezug auf den Mittelgesichtsbereich schlagen wir, je nach zu behandelndem Problem, 3 verschiedene Lifting-Techniken vor. Entscheidend sind sowohl die richtigen Zugvektoren als auch die Notwendigkeit einer Entfernung der überschüssigen Haut zu berücksichtigen. Die Verfahren können auf spezielle Bedürfnisse angepasst werden, wie im Bereich des Jochbeins, Unterlidfehlstellung, Tränensackdeformation usw.

Für die jeweiligen Indikationen und Techniken werden in dieser Übersichtsarbeit beispielhaft verschiedene Fälle vorgestellt.

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