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[Subperiosteal face-lift].
The "facial mask" is composed of all of the tissues lying on top of the skeleton: periosteum, deep adipose tissue, superficial musculo-aponeurotic tissue and skin. The periosteum is the intermediate zone between the skeleton, responsible for the shape of the face, and the more superficial tissues which complete the shapes and, most importantly, represent the mobile part of the face and consequently the site of facial expression. The secret of an effective "mask-lift" depends on complete subperiosteal dissection of the malar bones, zygomatic arches and orbital margins. This dissection can be performed via a coronal approach, but it is easier to start the subperiosteal dissection via a short vestibular incision. Subperiosteal dissection via a coronal incision is not only useful to lift the facial mask; it is also useful for remodelling the orbital margins and to obtain bone grafts from the parietal area in order to reinforce the glabella, check bones and nasogenial folds.
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