Re-Examination of the Maxillary Vestibular Approach with Emphasis on Facial Mimetic Muscle Preservation

Introduction: The standard Keen's or the maxillary vestibular incision allows direct access to the zygomatico-maxillary complex with inadvertent transection of the facial muscles and more laborious visualisation of the zygoma. Materials and Methods: We describe modifications to the vestibular and Keen's technique, based on identification and re-orientation of the facial muscles as well as utilisation of anatomical gaps between the facial mimetic muscles. Conclusion: Our modifications are based on the principle of facial mimetic muscle identification, preservation and re-orientation to near normal anatomy.