Authors of section

Authors

Nicolas Homsi, Paulo Rodrigues, Gregorio Sánchez Aniceto, Beat Hammer, Scott Bartlett

Executive Editors

Edward Ellis III, Eduardo Rodriguez

General Editor

Daniel Buchbinder

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Midfacial degloving approach

The midfacial degloving approach is usually performed in three steps:

  • Bilateral maxillary vestibular approach and subperiosteal dissection
  • Circular incision of nasal entrance
  • Degloving of the nose, nasal radix, and ethmoid region

1. Bilateral maxillary vestibular approach and subperiosteal dissection

This technique is described in the maxillary vestibular approach. Click here to read a step-by-step description of the maxillary vestibular approach.

Midfacial degloving approach

2. Circular incision of nasal entrance

The circular endonasal incision and soft-tissue dissection is achieved using a combination of three techniques:

  • Intercartilaginous incision (A)
  • Transfixion incision (B)
  • Incision of the nasal floor along the piriform aperture (C)

The illustration shows the soft-tissue situation after the endonasal circular dissection. The upper lateral cartilages are left in place connected over the anterior septal border and linked to the cranial margin of the piriform aperture.

Midfacial degloving approach

3. Degloving of the nose, nasal radix, and ethmoid region

After intranasal freeing, the soft-tissue envelope over the nose and the midface can be lifted in a subperiosteal and subperichondrial plane all the way up into the ethmoid region.

Midfacial degloving approach