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Technique

Tendon harvest

For midface resuspension, a longer tendon is often required. As a result, the plantaris longus is the preferred option.

Options to identify the tendons include:

  • Preoperative MRI
  • Intraoperative exploration

Other tendon options include palmaris longus or long extensors of the toes (3rd or 4th).

The full length of the selected tendon is harvested.

Advantages of using a tendon graft

  • Resists lengthening
  • Lower relapse rate
  • Small scar
  • Very long sling (especially with plantaris longus)
  • Minimal to no donor deficit

Disadvantages of using a tendon graft

  • Separate donor site scar
  • Tendon absent in some patients (plantaris longus, palmaris longus)

Other suspension options include acellular dermal matrix, fasciae latae, Gore-Tex or other alloplastic materials.