Aesthetic Plastic Surgery

, Volume 42, Issue 3, pp 774–790 | Cite as

Elimination of Aesthetic Deformations of the Midface Area Our Experience

  • Marlen Sulamanidze
  • George Sulamanidze
  • Constantin SulamanidzeEmail author
Original Article Facial Surgery



The aesthetic manifestations of the aging process in the cheekbone, cheek and infraorbital areas are especially concerning for patients, so rejuvenating interventions in these areas are most in demand.


To introduce the experience of our clinic for aesthetic manipulation using Aptos (anti-ptosis) thread lifting methods in the midface area.


Among the surgical interventions that we used were Aptos thread lifting methods both in combination with lower blepharoplasty, and without it. At the same time, special attention was paid to the individual approach, trying to minimize invasiveness and, most importantly, trying to achieve the effect of moving subcutaneous soft tissues to a new, more advantageous position from an aesthetic point of view, with their fixation to dense structures.


The results of application of the presented methods to lift the cheek–zygomatic and infraorbital regions using Aptos methods were studied. In the overwhelming majority of cases, the results satisfied both surgeons and patients.


Aptos methods for lifting the midface soft tissues, which we used, are quite effective for rejuvenating the aging face.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Midface Face lift Nasolacrimal furrow Nasolabial fold 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Supplementary material

Insertion of Aptos thread into the fatty tissue (MP4 18623 kb)

Implantation of Aptos Thread 2G to the midface area (MP4 25785 kb)

Scheme and implantation of Aptos Needle 2G to the midface area (MP4 65743 kb)

Intraoperative insertion of Aptos Thread 2G to the midface (MP4 174087 kb)

Intraoperative suturing of midface using Aptos Needle 2/0 (MPG 16102 kb)


  1. 1.
    Fournier PF (1991) Liposculpture: the syringe technique. Arnette-Blackwell, Paris, pp 273–409Google Scholar
  2. 2.
    Ramirez OM (1997) Cervicoplasty: nonexcisional anterior approach. Plast Reconstr Surg 99:1576CrossRefPubMedGoogle Scholar
  3. 3.
    Little JW (2000) Three-dimensional rejuvenation of the midface: volumetric resculpture by malar imbrication. Plast Reconstr Surg 105(1):267–285CrossRefPubMedGoogle Scholar
  4. 4.
    Freeman SM (2000) Transconjunctival sub-orbicularis oculi fat (SOOF) pad lift blepharoplasty. Arch Facial Plast Surg 2:16–21CrossRefPubMedGoogle Scholar
  5. 5.
    Fournier P (2004) Les variants dans la technique du Curl Lift, La revue de chirurgie esthetique de langue Francaise. t. XXVIII n 117:35–38Google Scholar
  6. 6.
    Benito J, Pizzamigio R, Teodorou D, Arvas L (2011) Facial rejuvenation and improvement of malar projection using sutures with absorbable cones: surgical technique and case series. Aesthet Plast Surgs 35:248–253CrossRefGoogle Scholar
  7. 7.
    Sasaki GH, Cohen AT (2002) Meloplication of the malar fat pad by cable-Suture technique for midface rejuvenation outcome study (392 cases–6 years experience). Plast Reconstr Surg 110(2):635–654CrossRefPubMedGoogle Scholar
  8. 8.
    Sasaki G, Komorowska- Timek E, Bennett D, Gabriel A (2008) An objective comparison of holding, slippage, and pull-out tensions for eight suspension sutures in the malar fat pads of fresh-frozen human cadavers. ASJ 28(4):238–396Google Scholar
  9. 9.
    Sulamanidze M, Sulamanidze G (2009) Aptos suture lifting methods. 10 years of experience. Clin Plast Surg 36(2):281–306CrossRefPubMedGoogle Scholar
  10. 10.
    Sulamanidze MA, Sulamanidze GM, Sulamanidze CM (2013) Midface thread lifting: method of internal suturing. In: Serdev N (ed) Miniinvasive face and body lifts—closed suture lifts or barbed thread lifts. Intech PublishingGoogle Scholar
  11. 11.
    Sulamanidze M, Sulamanidze G, Sulamanidze C, Borovikov A (2013) The long-term results of minimally invasive facial interventions are comparable to a deep lift. Plast surg Cosmetol 1:383–393Google Scholar
  12. 12.
    Adamyan A, Skuba N, Sulamanidze M, Khusnutdinova Z (2002) Morphological foundations of facelift using APTOS filaments. Annals of Plastic Reconstructive and Aesthetic Surgery 3:19–27Google Scholar
  13. 13.
    Mendelson BC, Muzaffar AR, Adams WP (2002) Surgical anatomy of the midcheek and malar mounds. Plast Reconstr Surg 110(3):885–896CrossRefPubMedGoogle Scholar
  14. 14.
    Rohrich RJ, Pessa JE (2007) The fat compartments of the face: anatomy and clinical implications for cosmetic surgery. PRS 119(7):2219–2227Google Scholar
  15. 15.
    Rohrich RJ, Pessa JE (2008) The retaining system of the face: histologic evaluation of the septal boundaries of the subcutaneous fat compartments. PRS 121(5):1804–1809Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  1. 1.Limited Liability Clinic Total Charm and APTOS CompanyMoscowRussia
  2. 2.Limited Liability Clinic Total Charm and APTOS CompanyTbilisiUSA

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