With age, the cheek migrates inferiorly and nasally. This contributes to inferior orbital rim hollowing, a circle effect to the lower eyelids and cheek, a flattening of the cheek, cheek bags (festoons), and nasolabial folds. In the past, these problems have been treated with facelifts, excision of cheek bags, and cheek implants. The cheek/midface lift procedure is performed by suspending an orbicularis muscle flap along with a tarsal strip. The operation places the ptotic cheek in a more normal position, relieves cheek bags, fills in the hollow inferior orbital rim with cheek fat, makes the midface more convex, and decreases the nasolabial fold depression. It also gives the effect of cheek implantation, adds skin to the lower eyelids for treatment of cicatricial ectropion, and reduces the hollowing of the lower eyelid that occurs sometimes secondary to overzealous fat removal in lower blepharoplasty. At times, the procedure is performed with lower eyelid fat excision, and at times, it is done with repositioning of the nasal and central lower eyelid fat pads into the inferior orbital rim hollowing area along with temporal fat resection. The tarsal strip procedure is performed to stabilize the lower eyelid and to prevent retraction and ectropion of the lower eyelid.
KeywordsCheek Midface Tarsal strip Eyelid circles Eyelid ectropion Fat repositioning Orbicularis flap Canthoplasty
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