Novel Approach for Midface Attractiveness.

We previously reported the Point A-Koji method, which uses a titanium plate to move the soft tissue Subnasale (Sn) point forward. This method improves the nasolabial angle, but it is not effective in nasal ala base depression. Various treatments for midface depression have been devised; however, each method has its own disadvantages. Therefore, we developed a minimally invasive method (A-10 surgery), in which an artificial dermis is inserted into the nasal ala base in combination with the Point A-Koji method, and performed it on a patient who has midface depression. Methods: The patient was a 34-year-old woman with midface depression and mouth protrusion' and her Sn point was located posteriorly. We provided A-10 surgery for this patient. Results: Six months after A-10 surgery, the following results were obtained: (1) the facial convexity increased by 3.7 degrees preoperative and postoperative surgery, (2) the soft tissue thickness at the nasal ala base increased by 2.15 mm from 7.42 mm preoperatively to 9.57 mm postoperatively, and (3) the postoperative computed tomography values of the tissue in the same area ranged from -11 to 250 Hounsfield units, suggesting that the inserted artificial dermis was established as dermal-like tissue. A-10 surgery improved the esthetic appearance of the midface. Conclusions: With A-10 surgery, which utilizes a titanium plate as a frame, the facial morphology of the patient changed owing to autologous tissue filling. In addition to being safe and minimally invasive, A-10 surgery yielded a three-dimensional appearance of the midface.