Prevention & Safety

Common Errors

Knowing the pitfalls is the first step to avoiding them. Learn from errors — without making them.

Error

Deepening dissector in midface

Consequence

Zygomatic branches or buccal loop injury (paralysis)

Solution

Always tilt dissector toward surface (upward)

Error

Dissecting toward lower eyelid

Consequence

Entry into orbital septum, prolonged chemosis (>1 month)

Solution

Aim from eye corner to nasal ala/mouth corner

Error

Too superficial dissection in temporal region

Consequence

Frontal nerve branch injury

Solution

Ensure plane between STF and DTF, over temporal muscle

Error

Not fully releasing orbital rim

Consequence

Limited elevation, asymmetries, insufficient result

Solution

Aggressive lateral, superior, and medial release until subcutaneous is visible

Error

Sutures too low or anterior

Consequence

Frontal nerve pinching or irritation

Solution

Position sutures as posterior and superior as possible

Error

Closing scalp with tension

Consequence

Edge necrosis, alopecia, widened scar

Solution

Traction in deep layers, not skin

Non-Negotiable Safety Rules

Never cauterize without direct visualization in midface

Never perform frontalis muscle myotomy (asymmetry risk)

Never position sutures too low or close to eyebrow

Never close scalp with tension

"The most common error in the learning curve is rushing to reduce surgical time. The transition from visual dependency to tactile navigation takes time. Respect this process."

— Dr. Robério Brandão