Fig. 5.

Intraoperative view of a patient undergoing a vertical upper-midface lift (SUM-lift). The soft tissue of the cheek is freed from underlying bone through a buccal incision using a custom-made periosteal rasp. The dissection extends from the nasal spine to the lateral buttress of the maxilla; it frees the tissue around the pyriform aperture, over the frontal process of the maxilla along the inferior and lateral orbital rim, around the infraorbital nerve, then vertically up to the frontal process of the zygoma to the level of the lateral canthus, and laterally over the zygoma body to the zygomatic arch