Endoscopic subperiosteal midface lift: Surgical technique with indications and outcomes

Scot A. Sullivan, Roger A. Dailey, T. Roderick Hester, Clifton D. McCord

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Purpose: To review the surgical technique of the endoscopic subperiosteal midface lift and present our clinical outcome in 22 consecutive patients. Methods: We retrospectively evaluated the clinical outcomes of 39 endoscopic subperiosteal midface lifts in 22 consecutive patients. Of the 39 sides, 21 had a lower eye conjunctival spacer graft inserted (15 hard palate mucosal graft, 6 AlloDerm). The success of the procedure was graded based on the aesthetic and functional results. Subjective and objective assessments were made using history, examination, and photos. Results: Results for the clinical outcome were graded as excellent, good, fair, or poor. Among the 39 sides, indications for the procedure included facial rejuvenation (41%), postblepharoplasty lower eyelid retraction (26%), eyelid retraction secondary to midfacial ptosis (15%), severe cicatricial ectropion (13%), and paralytic ectropion secondary to 7th nerve palsy (5%). The operating surgeons evaluated the clinical outcome as "excellent" in 24 sides (61%), "good" in 10 sides (26%), "fair" in 2 sides (5%), and "poor" in 3 sides (8%). The procedure was successful at increasing malar projection, improving lower eyelid fullness, and elevating the lower eyelid in cases of lower eyelid retraction. The procedure was less effective in decreasing the prominence of the deep nasolabial fold. Conclusions: The endoscopic subperiosteal midface lift is an effective method for elevating the midface. A more youthful appearance is achieved with the procedure, and when necessary, recruitment of anterior lamella allows elevation of the lower eyelid to correct retraction.

Original languageEnglish (US)
Pages (from-to)319-330
Number of pages12
JournalOphthalmic plastic and reconstructive surgery
Issue number5
StatePublished - Sep 2002

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology


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