Post bleph patient

Repair tear trough drill, suture fixation of SOOF, combined in SMAS repair of face.

Primary Patient

Combined with endobrow, open face repair.

(Same Patient as above)

Midface - drill, suture fixation, entry into lower lid fat pads and teasing them into "tear trough".

Showing pre-operative markings of vector with result - one (1) year post-operative.

Primary patient

Combined with open lift, no orbital fat removed teased down to soften junction between SOOF repair and orbital rim to avoid post-op "hollowness".

Previous open lower lid bleph patient

No external incisions. Intraoral release capsulo-palpebral, drill and suture fixation of SOOF to intra orbital rim.

Vectors show descent typical in aging.

Blue marks on skull and drawing depict area where oblique drill hole is placed. (Aesculap power), 3-0 nylon suture is brought through and sutured to SOOF. The lower lid fat pads are treated at this juncture.

Intraoperative view: red arrow demonstrates SOOF elevation and fixation intraorally. On the inferior view note the "tear trough" changes.