Temporal Stage Detachment

We perform a deep temporal incision parallel to the hairline, as previously described, leading straight to the white temporal fascia (Fig. 45.3). Medially, the entire temporal crest is released and the frontal subperi-osteal dissection includes the upper orbital rim with a restriction area under the eyebrow medial third to prevent any supraorbital nerve injury. The whole procedure is nonendoscopic, as described for the open mask lift procedure. The subgaleal posterior detachment must be extensive in order to absorb all the tissue excess resulting from the suspensions, without any intracapillary resection.

The lower dissection of the temporal area is more delicate and we advise, in order to avoid nerve injuries, reaching the lateral orbital rim first and following the temporal crest forward, always keeping a bony contact. Then, a posterior movement with the elevator allows a safe deep temporal fascia detachment and facilitates its junction with the previously performed orbitomalar subperiosteal detachment (Fig. 45.4).

Fig. 45.3. The temporal incision

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