Transblepharoplasty: subperiosteal approach to rejuvenation of the aging midface.

Multiple approaches are available to rejuvenate the aging midface. Our preferred technique is a graduated transblepharoplasty approach beginning with lower blepharoplasty with or without orbital fat repositioning and progressing to a subperiosteal midface lift, guided by the extent of aging changes present in the midface. In this article we discuss the rationale for this method and describe the preoperative analysis, relevant anatomy, surgical technique, postoperative considerations, and complications associated with each technique. Case examples are provided to illustrate major concepts.