Midface-lift-aesthetic options for the infraorbital region

Treatment of the periorbital region is still a very demanding surgical procedure. In addition to the operation itself the correct preoperative diagnostics play an important role. In this context an important feature is the differentiation between positive and negative vectors. Patients with a negative vector have a high risk of postoperatively developing a lower eyelid malposition. For this reason, patients with a negative vector and a pathological value with the Hertel exophthalmometer are no longer routinely treated with a classical lower eyelid correction. Instead the subperiosteal midface-lift according to Hester has become established as the standard procedure. The most effective means of treatment of lacrimal sacs with a negative vector and malar bags is a subperiosteal midface-lift. It reduces the eyelid-cheek distance and blends the periorbital retaining ligaments. Furthermore, it confers volume to the lower eyelid and provides a stable support. Due to the nature of the procedure a previously existing negative vector is transformed into a neutral or even positive vector. In experienced hands the midface-lift is the ideal procedure for treatment of malar bags and the aesthetic correction of lower eyelids with a negative vector.