Midface procedures can greatly enhance the overall appearance of the face, whether in isolation or combined with other more traditional facial rejuvination surgeries, such as facelifting or blepharoplasty. Just recently, plastic surgeons have begun to appreciate the significant role of the midface in the aging process.
The midface is the area below the lower eyelid and above the corner of the mouth that lies to the side of the nose. This region is made up the the cheek and facial bones, muscles of expression, and two fat pads; the SOOF (sub-orbicularis occuli fat pad) and the malar fat pad. Descent of the skin and fat in the region leads to hollows beneath the eye (nasojugal grooves), deepening of the nasolabial folds, and downturning of the corners of the mouth. Elevation of the midfacial muscles and malar fat pads helps to rejuvinate the lower eyelid, mouth, and cheek at the same time. Facelifting procedures typically do not address these concerns very well.
Minimally invasive procedures for midfacial lifting include thread lifting and suture lifts. These procedures are excellent for patients with mild to moderate midfacial aging that want to avoid formal surgery and general anesthesia.
Endoscopic midface lifting is also known, as you point out, as subperiosteal midface lifting. This is a more formal procedure which requires general anesthetic. Patients with moderate to severe midface aging are helped tremendously by it. Small incisions are made behind the hairline and the midface is elevated along the facial bones, hence the term sub-periosteal. Sutures or absorbable implants are then placed to hold the midface up until the tissues heal in their new location.
In the appropriately selected patient, midface lifting can produce a very natural and lasting surgical result. The problems you describe seem to be exactly the type that surgeons look for in a midface lift candidate. Obviously, a formal consultation is required to definitively determine if this procedure is right for you.
