Midface Lift Plus Lipofilling Preferential in Patients with Negative Lower Eyelid Vectors: A Randomized Controlled Trial
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ORIGINAL ARTICLE
OCULOPLASTIC
Midface Lift Plus Lipofilling Preferential in Patients with Negative Lower Eyelid Vectors: A Randomized Controlled Trial Mauro Barone1,2,3 • Annalisa Cogliandro1,2 • Rosa Salzillo1 • Silvia Ciarrocchi1 Alaa Abu Hanna1 • Vito Russo1 • Stefania Tenna1 • Paolo Persichetti1,2
•
Received: 16 July 2020 / Accepted: 7 September 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Abstract Introduction In conducting this study, it was our presumption that lipofilling is a necessary and simultaneous adjunct to lifting the middle third of the face in patients with negative lower eyelid vectors, enabling satisfactory and enduring aesthetic results. Materials and Methods Eligible patients met the following criteria: (1) primary midface lift in subperiosteal plane; (2) negative inferior eyelid vectors at preoperative baseline; (3) postoperative monitoring for * 2 years; (4) standard pre- and postoperative photo-documentation; (5) proficiency in Italian language; and (6) signed consent for study participation. Informed consent pertaining to photography allowed for subsequent publication. Pertinent patient data were also collected as follows: age, sex, duration of followup, type of surgical procedure, related secondary procedures, quantity of fat injected, nature of incision, and patient satisfaction level. Complete randomness was thus conferred during computer-assisted patient assignment to one of two study arms: midface lift only (group 1) or midface lift plus facial lipofilling as a concurrent operation (group 2). All patients completed Italian versions of the FACE-Q module, which were issued by e-mail & Mauro Barone [email protected] 1
Plastic and Reconstructive Surgery Unit, Campus BioMedico University of Rome, Via Alvaro Del Portillo 200, Rome, Italy
2
Research Group ‘‘To be and to Appear: Objective Indication to Plastic Surgery’’, Campus Bio-Medico University in Rome, Rome, Italy
3
Institute of Philosophy of Scientific and Technological Activity, Campus Bio-Medico University of Rome, Rome, Italy
approximately 2 years postoperatively. Two plastic surgeons reviewed all postoperative photographs of treated patients and rated outcomes on a scale of 1–5. Statistical analysis was powered by standard software expressing categorical data as numbers and percentages and quantitative data as means ± standard deviations. Results Between January 2016 and March 2018, a total of 56 patients (women 48; men 8) subjected to primary midface lifts in subperiosteal plane at our Plastic Surgery Department met all criteria for study enrollment. Mean patient age was 56.5 years (range 40–70 years), and the mean follow-up period was 2.1 years (range 2–5 years). Differences in postoperative FACE-Q scoring by the two groups were significant (p \ 0.01) across all domains. Outcomes in patients of group 2 remained stable during long-term follow-up, whereas significantly more secondary procedures were pursued by patients of group 1 (
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