Abstract
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.
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