The Perfect Facelift According to World Renowned Plastic Surgeon Oscar Ramirez

Standard facelift techniques are ideal for correcting the line of the lower jaw and neck. As for the area between the lower eyelid and the corner of the mouth, the development of operational techniques is necessary here. Alternative methods of subperiosteal dissection with access in the lower eyelid have shown good results.

Their disadvantage – an increase in the number of complications. These methods are two-dimensional work with the soft tissues of the face. Whereas Professor Oscar Ramirez, a pioneering American College of Plastic Surgeon certified plastic surgeon, presents a different approach – the best in terms of safety and possible complications. 

Problems and Solutions in Midface Correction

The effectiveness of standard facelift techniques decreases with a pronounced aging process in the area between the corner of the mouth and the lower eyelid. Other methods that have been effective in treating the nasolabial fold and sagging cheek have not been effective in correcting this difficult area: the V-shaped deformity of the junction of the lower eyelid to the cheek, which is not as well understood as the tear trough deformity.

In order to correct this critical area, it was necessary to develop new techniques. The common denominator of the new techniques was dissection in the intermediate layer of the face. 

A subperiosteal facelift is a viable alternative for midface correction, including V-shaped deformity. The positive effect of the subperiosteal lift extended to the entire periorbit in the form of periorbital plasty with the movement of not only the bases of the muscles of the middle zone, but also m. orbicularic oculi by 300 degrees in circumference.

This technique in combination with Hinderer et al. – the first effective method of influencing this zone. 

What criteria should an ideal facial rejuvenation meet

In my opinion, the ideal rejuvenation should:

1. Ensure volumetric remodeling of the cheek.
   2. Allow skeletal support to be affected by augmentation and reduction without additional incisions or dissections in other cavities.
   3. Allow lipografting without the risk of migration or the need to fix other tissue grafts.
   4. Fix fat hernias on the lower jaw.
   5. Correct V-deformity of the border of the lower eyelid and cheeks.
   6. Tighten the corner of the mouth.
   7. Give the possibility of affecting the skin layer in one surgical procedure access without risk of skin necrosis or prolonged healing.
   8. Minimize facial swelling.
   9. Minimize facial numbness.
   10. Minimize trauma to the facial nerve.

What are the highlights of midface rejuvenation?

Perfect mid-zone rejuvenation should not rely on:

1. Canthopexy or canthoplasty for cheek lift.
2. Canthopexy or canthoplasty as primary or secondary manipulation to prevent malposition of the eyelid.
3. Tension and stretching of soft tissues, which can lead to folds and stretch marks in the cheekbone area. 
4. Transverse incisions m. orbicularis oculi.
5. Dissection through the intermediate layer of the face, where the muscles and nerves of the face are located.

On September 2-3, 2016, Oscar Ramirez will visit Ukraine as part of the Visiting Professor Program II, which will be held in Kyiv under the auspices of ISAPS.
On the program September 2-3 live surgery from Dr. Ramirez:
• & laquo;Complex endoscopic and minimally invasive facial rejuvenation»
• "Surgical correction of the external nose"
• Lecture and video presentation: "Endoscopic techniques for forehead rejuvenation and mid-face lift"