Fixation & Support
Fixation Vectors
The vertical vector is the Endomidface signature. Understand fixation logic and how to ensure lasting results.
Unlike traditional facelift techniques that pull tissues backward (posterior vector), Endomidface promotes vertical elevation — upward, against gravity. This technical decision has two fundamental consequences: we don't need to release the strongest lateral ligaments (especially the zygomatic), and we reduce manipulation of dangerous zones.
Fixation Points
Lateral Fixation
Sutures on deep temporal fascia, as posterior and superior as possible.
- → Material: Vicryl 2-0
- → Goal: elevate mobilized SMAS flap
- → Protection: position posterior to incision to avoid frontal nerve
Medial Fixation
Muscle flap from temporalis to anchor medial portion of midface.
- → Flap of ~0.5-1 cm of temporal muscle
- → Allows adequate vertical traction
- → Essential where temporal muscle isn't directly available
✕ Lateral Vector (Incorrect)
- Backward traction toward ear
- "Stretched" unnatural appearance
- Short-lasting result
- Requires releasing strong ligaments
✓ Vertical Vector (Correct)
- Upward elevation against gravity
- Natural "top model look" result
- 8-12 year durability
- No need to release lateral ligaments
"Our intention is to pass in front of the ligaments, dissect everything in front, and reposition upward — not backward. That's why it's possible. That's why it's safe."