Temporal Modified Orbicularis Repositioning: Going beyond the Limits of Temporal Lifting

Abstract

Background: Periorbital rejuvenation is often challenging and requires comprehensive evaluation of its various components to obtain satisfying results. Considering the crucial role of the orbicularis muscle in the periorbital aging process, the first author recently described his personal technique for temporal lifting through a subcutaneous approach in conjunction with an orbicularis muscle flap. In the current article, the authors present a modified and extended temporal lift approach that allows for remarkable improvement, not only in the temporal and brow region but also in the entire periorbital area up to the malar region; therefore, it is named temporal modified orbicularis repositioning (MORE).

Methods: A total of 212 consecutive patients underwent temporal MORE performed by the same surgeon between May of 2021 and September of 2022. Each patient completed a FACE-Q questionnaire preoperatively and 12 months postoperatively. Five independent surgeons were asked to score the results evaluating patients' preoperative and postoperative photographs.

Results: No major complications were recorded. The most satisfying aspect of this technique was dramatic periorbital rejuvenation noticeable in all patients. FACE-Q preoperative score was 34.29 ± 5.872, whereas postoperatively it was 80.11 ± 6.796 ( P < 0.05); delta (after - preoperative) mean value was 45.82 ± 8.925. The surgeons' questionnaire mean value was 41.92 ± 6.010. Statistical analysis showed a strong correlation between surgeon and patient satisfaction ( r = 0.7488).

Conclusions: Temporal MORE proved to achieve a comprehensive rejuvenation of the periorbital area in a straightforward and reproducible way, with a fast recovery and a low complication rate. In this cohort, patient satisfaction with the result was remarkable and comparable to the judgment of the surgeons interviewed.

Clinical question/level of evidence: Therapeutic, IV.