How many ways are there to do a mid face lift? How do you know which is best for you?
Are There Different Types of Mid Face Lift?
Doctor Answers (16)
Different Types of Mid Facelift
Question: Are there different types of mid facelift?
Answer: There are many types of the facelift procedures and there are different approaches to the mid face including a direct open approach, endoscopic approach, modified endoscopic approach, approach through the lower eyelids. In general, I do not like to take one portion of the face out of context with the remainder of the face and neck. It is important to have a nice smooth contour of the mid face, lower face (jowl/jawline region) and neck. Taking one part out of context runs the risk of distortion.
Accordingly, I usually prefer to approach the mid facelift at the same time as I am approaching the remainder of the face, jawline and neck. There is better visualization with access to important anatomical structures for redraping of the appropriate structures in a manner to achieve natural smooth contours.
Different types of midface lifts or cheeklifts - pros and cons
There are basically several types of midface lifts / cheeklifts. Each does a different thing. The cheek is the trickiest area on the face, and if incorrectly done, they can be a disaster. However, the aesthetic rewards are enormous in that the cheeklift is a powerful tool.
There are the through the lower eyelid surgeries. These are best at smoothing out the eye-cheek junction. They are riskier if they violate the orbital septum. Our version is an ultrashort incision procedure that does not violate the orbital septum, the USIC(TM) cheeklift. Through the lower eyelid cheeklifts can be done at the suborbicularis level or the subperiosteal level. We believe the suborbicularis level (more superficial) is safer. We often combine the USIC cheeklift with LiveFill(TM) grafts to the lower eyelid, but very judiciously to minimize the chance of bulging. There are mini versions of these procedures, and maxi versions. Each has a place in the right patient.
Cheeklifts can be performed through the temple / inside the mouth. These cheeklifts completely avoid lower eyelid problems, but also do not correct the eye-cheek junction. They can cause an increase in the intermalar distance, the distance between the cheeks. They can also cause a upward of "catlike" appearance of the outer eye. They are powerful in what they do and valuable in the right patient.
Endotine type lifts are also cheeklifts. These can be performed through the temple. Hooks of self dissolving material are placed below the cheekpad, elevating it. Patients note sensitivity to the endotine devices or the fixation devices. Bunching in the side of the eye can be noted. An alteration in the distance between the cheeks can occur.
Transconjunctival approaches. It is possible from the inside of the eye to elevate the cheeks slightly and to redistribute the fat from the lower eyelid. If the fat is redistributed, this requires that the orbital septum be violated (from the inside) to spill the fat our beyond the lower rim of the eye bone.
Whatever the approach, experience experience experience is key! The lower eyelid is a very delicate structure and a conservative approach is best. The rewards are great. The pulled down look of the older blepharoplasties can be eliminated in most cases, and certainly prevented by using midface techniques. Almost always, the entire face must be considered, not just the cheek, because the cheeklift has effects on other areas of the face.
A beautiful appearance of the lower eyelid area can be created that is simply not achievable with any other means.
Bad lower eyelid surgery can generally be fixed nicely. Bad aggressive cheeklift surgery is often unfixable.
You may wish to read the chapter we wrote in the plastic surgery textbook "Mathes" on midface lifts and browlifts.
There are many ways to perform a mid face lift. That answer alone will let you know that more than one approach will work and, also, no one approach is appropriate for everyone. Many surgeons prefer to perform a sub-periosteal mid face lift with incisions and suspension in the temple within the hair. Other surgeons use the same sub-periosteal approach but limit their incisions to the area underneath and in the natural skin crease of the lateral eye.
Many surgeons perform suture suspension mid face lift in order to reposition the descended fat. There are other approaches and different incisional techniques. Each of them has their advantages and disadvantages. I would suggest discussing with your surgeon which approach they have chosen and they will be able to tell you why.
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There are a number of ways to rejuvenate the midface but the most common cause of aging in the midface is loss of fat which makes fat grafting the best option for most people, such as in the link below
Types of Midface Lift
The midface is an important area of facial rejuvenation. A midface lift can be a good option for the appropriate candidate. Typically, a midface lift is performed through either a temporal incision (along the hairline) or in a transconjuctival incision (within the eyelid).
Different types of mid facelifts, same goal.
There are various types of mid facelifts. The central theme is to re-suspend the buccal fat pad. Another excellent alternative to a mid face-lift is to add volume to the cheeks with implants. They are easy to remove and replace and do a very nice job of replacing lost volume in the cheek rather than trying to raise the cheek. The down side of mid face/cheek lift is that there can be a bunching of skin along the lower eyes, which can give the eyes a smaller appearance.
The mid-face is the anterior cheek region from the nose medially to the lateral canthus of the eye laterally. In surgical terms rejuvenation requires lifting the tissue off the bone then anchoring it superiorly by various means. Here's the long and short of it; all the surgeries are the same. Sure the anchoring means may be different or the incision or incisions may be different but they all accomplish the same thing. I prefer an upper eyelid incision and an incision in the mouth. Other surgeons use one incision in the temporal hairline and use endoscopic equipment.
What matters is that the surgeon must be comfortable with their own approach and technique. They should also be able to explain why they do what they do and why it works for them.
There are many things for the midface
The midface is a very difficult area to rejuvenate, and I hear patients discuss many different options that they learn from other surgeons. People describe mid-face lifting through the lower eyelid incision. That can be risky in that the lower eyelid may droop, even if temporarily, resulting in an unhappy patient. The endoscopic approach, which we perform most often, utilizes a telescopic camera inserted in incisions in the hairline to dissect the cheek tissue and lift it.
Threads can also be used to lift up the cheeks in a patient where there is not too much heaviness. It is important to see a surgeon who specializes in these procedures so that the best procedure can be determined for you. Good luck.
Mid-facelifts are designed to lift the area of the cheek and also the loose tissue around the eyes.
There are two ways to lift the midfacial tissue:
- Through an incision of the lower eyelid. The loose soft tissues of the cheek are elevated and sutured to the bony lower eyelid ( infraorbital rim).
- Endoscopic technique where the incisions in the hairline at the temple. This incisions allows lifting of the loose tissue in the cheek and eye towards the area from which they drooped.
I prefer the Endoscopic technique because it allows better suturing and repositioning of the drooped cheek and eyelid tissue.
Hope this helps,
Just take a look at the large number of answers to this very important question and the great diversity of opinions. That will tell you that there is no easy or pat answer. My best advice is to ask your surgeon to show you pre and post op pictures, at least 1 year apart, and then ask what procedure did he/she exactly do. Then compare several doctors. There is no set answer, Different esthetic results and different facial features will demand different approaches. Good luck
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.