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Extract

Rod Hester continues to refine his midface and lower-orbital rejuvenative procedure. All surgeons working to correct aging changes of the face are the beneficiaries of his pioneering efforts.

Dr. Hester and his colleagues recently reported their cumulative experience in 757 patients using the trans-blepharoplasty approach for correction of lower-lid and midfacial aging.1 Although their results were undeniably impressive, they also reported a 19% surgical revision rate. More than half of the revisions were for lower-lid malpositions or canthal deformities.

Dr. Hester's article in this month's Operative Strategies section is an attempt to address this relatively high revision rate by using endoscopic assistance to limit dissection in the lower lid. He also emphasizes minimal lower-lid skin removal. In his current series, 25 patients have been treated with the endoscopic approach, and only 1 patient (4%) required surgical correction of lower-lid malposition. Although these results must be regarded as preliminary, the reduction in surgical revision rate is encouraging.

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Operative Strategies
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