Are All Midface Lifts Done Endoscopically These Days?

Is it now common for the procedure to be done endoscopically? Are there any advantages to having mid facelift done NOT endoscopically (can you see more, have more control, precision)? Is it enough the "standard of care" that I should look skeptically at a surgeon who doesn't do this procedure? I'm thinking of having it done to improve the sagging of my cheeks but not sure its the right procedure.

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18 Doctor Answers | Asked by asiangal in cal in sf, ca

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Interesting question

When you ask "standard of care" questions, it sounds like you are an attorney! That said, they are different techniques for addressing the same area, but with different goals (slightly). Either may be appropriate given findings at exam. For myself, I like the open approach for the midface generally speaking, so I will only address this part of your question. Open technique will allow for removal of excess skin. Also, the SMAS (strength layer under the skin, and over muscles)... more

Be careful what you wish for

Dear Asiangal First, it is important for you to understand that all midface surgery is so individualized that no one can exactly predict the outcome of the procedure. Essentially, it represents a type of surgical experiment. This means the potential outcome and your satisfaction are unknown and unforeseeable! Second, with the exception of my published method of performing a vertical midface lift through the lower eyelid, all other midface surgeries involve pulling up the cheek fat from a... more

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

Mid facelift can be done endoscopically or open

A mid facelift can be done endoscopically or open depending upon the surgeon’s choice. An additional procedure that works quite well for volumetric augmentation of the cheeks is a cheek augmentation procedure. Silastic implants are placed through a gingival incision to volumetrically augment the cheek area. Cheek augmentation is a reversible procedure, as the implants can always be removed. Mid facelifts can make the eyes look smaller.

Midface lifts can be performed open or endoscopically

All midface lifts are not done endoscopically and there is no "standard of care" for techniques. I would be more suspect of someone who tells you that any particular operation needs to be done any particular way. There are advantages and disadvantages to every technique and no specific technique can guarantee a result. The miface is a confluence of the lower lids, cheek, and nasolabial folds. This area of the face must take into account the complex anatomy of the skin, fat,... more

No, there are many approaches

Looking at your photo, even with a slight smile, your cheek soft tissues are sagging. The good news is that you do not have jowls, or loose skin on the neck and it looks that you have good skin elasticity. I prefer to do a mid cheek lift via a small incision in the gum line just above the teeth. There's also a small incision in the temporal area in the hair bearing scalp (I part the hairs, do not shave them). I often combine a mid cheek lift with a lateral brow lift done through the scalp... more

Many techniques

Midfacelifts are performed in many different ways. There really isn't a procedure that qualifies as the standard of care as with most facial plastic procedures. I prefer a midface lift via a percutaneous technique with gortex suture, however, endoscopic lifts are also commonly performed.

Open midface lift is most commonly done and has advantages

Most experienced surgeons are still using traditional open face lifting techniques. There are many complex reasons, but the most important are that traditional methods produce a more reliably excellent result and in my opinion are safer. The open approcah allows for more accurate re-draping of the cheek and skin, removal of damaged excess aged skin, and a more thorough restoration of the youthful cheek by restoring the malar fat pad to a proper position. Limited visibility through the... more

It is the right procedure for you!

First and foremost, from you photo, you look like an excellent candidate for a mid face lift. You cheeks have fallen and you have developed a crease above your Nasolabial fold. You do not have jowling or loose skin in your neck. You still have fullness but it has migrated south. Doing a mid face lift will correct your problem without needing a more extensive face lift at this time. As far as how the procedure is performed, some surgeons use a endoscope and others do not. This however should... more

Midface lift should not be done endoscopically.

Hi! 1) Offering a midface lift to the appropriate patient is "standard of care" for a plastic surgeon treating the aging face. 2) In New York, we do a midface lift with an incision in the temple behind the hair and an incision inside the mouth. It's done under direct vision with fiberoptic lighting, and there are no visible scars. There is no role for endoscopy. (We do endoscopic brow lifts, but that is another issue.) 3) You look like a good candidate for a midface lift. ... more

It depends on the surgeon and the surgery.

You do look like you would benefit with a cheek lift. How it is done is very important and you should choose a very experienced surgeon who has done hundreds of these. He will be able to guide you as to the pros and CONS of each way of doing the operation. We do all of the various approaches and tailor the operation to the patients goals. A good surgeon will discuss multiple ways of doing the operation and his results with each.