Lateral Cheeklift

Hello, this is Julian d Perry and I would like to discuss some key elements for performing a lateral cheek lift. First, a can otomy and can lysis is performed in the standard fashion. Then the conjunctiva is incised immediately inferior to the tarsal border, approximately to the mid pupil blunt dissection is then carried out towards the acus alis. This case has some additional scar tissue as it is a re-operation. Once the acus Ali is exposed, an incision is created about two millimeters inferior to the acus Ali. The periosteal elevator, or a cautery instrument is then used to create the subperiosteal dissection. In this case, a cautery instrument is being used in order to provide excellent hemostasis of the zygomatic, temporal and zygomatic facial arteries. You can see here that we can dissect very quickly using the cautery instrument. An incision is then created in the periosteum in order to free the cheek, and here you can see the wide extent of the pocket extending towards the buccal sulcus. Grasping. The soothe then results in excellent cheek elevation. The eyelid is then shortened in standard fashion. The mucocutaneous junction is excised. A small triangle of redundant skin is removed and a skin flap can be performed here as well. The S soThe is then advanced to the lateral aspect of the zygomatic periosteum. Using a four oh PDS suture. The suture is placed to the lateral aspect of the zygomatic periosteum and mattress fashion. This results in excellent cheek elevation. The eyelid is then resuspended to the inner aspect of the orbital rim. In this case, a temporary tar sophy is being placed. In other cases, I use a frost suture. The cantal angle is then reformed before tying the eyelid resuspension suture and the sthe advancement suture to make it easier to close the angle. The eyelid suture is then tightened and tied, and the cheek lifting suture is then tightened and tied. Finally, the skin is closed and this completes a lateral cheek lift. Thank you.