Trans-inferior orbital rim anchorage and fascia roll multi-loop temporal anchorage in midface rejuvenation.

[BACKGROUND] A paradigm promoted for midface rejuvenation by Besins in his reverse and repositioning effect (RARE) technique considers 3 vertical sectors of the face. It relies on thread-based suspensions of the malar area and the orbicularis oculi with long cable suture forehead anchoring.

[OBJECTIVE] The author reports on the use of short cable suture anchorage points as an alternative suspension method that helps to avoid and/or correct asymmetry and ectropion.

[METHODS] An oblique malar elevation with short cable suture transorbital anchoring, in conjunction with a Hester-Flowers orbicularis oculi transzygoma anchoring technique, was performed using a new technique for fascia roll, multi-loop temporal anchoring and auricular tightening.

[RESULTS] A series of 295 patients have undergone the procedure since Spring 2002, with follow-up of up to 31 months. A strong oblique malar elevation, focused on nasolabial fold correction, eyebrow elevation, and better jaw definition, along with a natural appearance of the face were found to be stable over time.

[CONCLUSIONS] Transorbital anchoring allows strong malar elevation and lower lid support for rejuvenation and correction of complications. It should be combined with a Hester-Flowers orbicularis oculi transzygoma anchoring technique and can be performed in conjunction with a fascia roll, multi-loop temporal lift, submental fat and partial submaxillary gland removal, and auricular tightening as part of a full face lift procedure.