Pitfalls of Midface Surgery

The document from 2005 by Vito C. Quatela and James C. Marotta reviews the complications associated with the endoscopic forehead midface lift, a procedure they have performed over 800 times. They report a 1% incidence of frontal branch paresis, with no permanent paralysis cases, and note that hypoesthesia and dysesthesia usually resolve within 6 months to a year. Other complications such as glabelar irregularities, abnormal brow position, and ptosis can be minimized with proper technique. Infections and hematomas are rare, occurring in less than 1% of cases, while prolonged edema and chemosis occur in 5% and 30% of patients, respectively, but are manageable. Canthal distortion requiring revision surgery was noted in 3 out of 800 patients. Temporary dry eye syndrome and permanent alopecia can be avoided with careful surgical practice, and masticatory tenderness typically resolves within 48 hours. The authors emphasize the importance of surgical expertise and patient education to minimize risks and achieve high patient satisfaction with the midface lift procedure.