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(d, f ) the route to the premammillary recess is crossed by and interthalamic adhesion, which can be found at di¤erent distan- ces from the floor of the third ventricle CHAPTER 7 Facial Plastic and Reconstructive Surgery 427 laserresurfacingtechniquesmaybeconsidered612months postoperatively Superficial Plane Technique originaltechniquedescribedinlate1960s addressesredundantskinonly Advantages: simple Disadvantages: does not address deep elements, interrupts vascular perforators to skin, higher risk of skin sloughing Deep Plane Technique (Hamra, 1990) subSMASdissectionfrommidfacetomedialmelolabialcrease, elevates cheek fat pad attached to skin by zygomaticus muscles, provides vertical lift Advantages: addresses melolabial crease and midface (malar fat pad) by separating SMAS from fixed bony attachments of zygomaticus muscles, provides an excellent jaw line, preserves structural integrity of facial blood supply Disadvantages: lengthy anterior dissection, persistent malar edema Composite Technique combinesadeepplanetechniquewithanorbicularisoculimuscleflap Advantages: repositions zygomaticus major to original position, healthy and thicker flap (less chance of sloughing, especially with smokers), more avascular dissection Disadvantages: persistent malar edema, requires some blind blunt dissection at curve of maxilla, unnatural tension of overlying skin of temple area Subperiosteal Technique variationsofsubperiostealunderminingoforbitalrim,zygomatic arch, maxilla, and zygoma body Advantages: maintains perforators to skin, excellent repositioning of lateral canthus, addresses midface without causing unnatural tension on skin (places traction on periosteum) Disadvantages: causes prolonged facial edema, increases intermalar distance, limited improvement of jowling, technically more challenging Multiplane Technique combinesanextendedSMASdissectionandadeepplanelift(allows free binary option robot 196 in subcutaneous plane to release zygomatic ligaments and skin of midface) 4.

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