A midface lift blends the lower lid or cheek junction

A midface lift, also known as a 'cheek lift,' blends the lower lid/cheek junction. It differs from a lower facelift or facelift, which addresses the lower two-thirds of the face. There are several different techniques that plastic surgeons utilize to address the midface, including techniques through the lower eyelid in both the subperiosteal and suborbicularis planes.

Other techniques can approach the midface from the temporal approach in the hair and from the mouth. Others will address the midface during a facelift. Many options exist, and every surgeon will have their preferred techniques.

In our practice, a cheeklift, a type of midface lift, is effective at smoothing the lower eyelids at the level of the cheeks, for slight elevation of the cheeks, and for reducing the hollowness below the lower eyelids (especially the LUSIC cheeklift with LiveFill).

Many people think of a cheeklift as an alternative to a facelift.  It is not.  It is a new procedure designed to make the lower eyelids and midface look better and less hollow.  It is also very valuable in correcting the appearance of the lower eyelids if they have had conventional subciliary eyelid surgery and have pulled down, rounded, or changed in appearance.  Cheeklifts typically do nothing for the jowls and not much for the nasolabial folds.

Some doctors try to perform aggressive lifts on the midface.  This is in my opinion a mistake.  Revision of aggressively done cheeklifts is in some cases almost impossible.  Midface lifts must be subtle.  Radically performed cheeklifts from inside the mouth/temple incision approach can cause a greatly increased intermalar distance (distance between the cheekpads), giving the face an odd cat-like appearance.  Aggresive elevation of the cheeks can cause bunching of the tissue beside the eye, necessitating aggressive lateral brow elevation.  Cheeklifts done through the lower eyelid at the subperiosteal level also have potential hazards with contraction of the orbital septum and pulling down of the lower eyelid (ectropion).

The lower eyelid tissue is so delicate and prone to problems that extraordinary care must be taken when operating on the midface.  It is arguably the most difficult area in plastic surgery.  It is not for the occcasional surgeon to perform cheeklift surgery.

Facelifts and minifacelift address the bottom two thirds of the face and the neck, not the area below the eyes.

But for the patient desiring a subtle reduction in hollowness below the lower eyelids, a subtle correction of midfacial descent or correction back to an almond eye shape in patients who have had conventional lower eyelid surgery before, a cheeklift can be just the right thing.

For a full discussion on different types of midface lifts, you may want to read my book chapter in Mathes Plastic Surgery:

http://www.drbrent.com/article_mathes.php

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