Transtemporal endoscopic multiplanar upper midface lift (MUM lift)

Abstract

Minimally invasive techniques have been successfully applied to aesthetic improvement of brow ptosis and forehead rhytids. Because the face tends to age vertically more than obliquely, it makes sense to perform the correction in a more vertical direction. We introduce an endoscopic vertical multiplanar upper midface elevation (MUM lift) that avoids extensive lateral temporal and preauricular incisions. Between 1996 and 2003, 53 patients (8 men and 45 women) underwent MUM lift, an endoscopic transtemporal sub-superficial musculoaponeurotic system (sub-SMAS) and subcutaneous upper midface tissue release with verticolateral repositioning and fixation, in combination with an endoscopic-assisted forehead lift and blepharoplasties. Use of the various planes of release in the midface produced less tension on each layer and provided natural and improved facial rejuvenation of the upper midface in conjunction with forehead rejuvenation. At 6 months postoperatively, significant rejuvenation of the nasojugal groove was achieved, although some drooping of the lateral brow position (mean, 2.3 cm) was observed. A transtemporal sub-SMAS and subcutaneous upper midface lift (MUM lift) in combination with limited incision foreheadplasty, reduces unnecessary vascular compromise on any particular layer and can be safely and predictably performed over the zygomatic muscle.