What is a midface lift? How is that different from a regular facelift or a mini face-lift?
What is a Mid-face Lift?
Doctor Answers 23
A midface lift is a procedure aimed at elevating the...
A midface lift is a procedure aimed at elevating the cheeks. A 'regular facelift' generally refers to a facial rejuvenation procedure aimed at improving the jowl (lower jawline) or neck area. A mini-lift is a minimal incision lower facelift which usually is used to adress the jowl area.
A midface lift can be performed using several techniques with various incisions. Silicone or other implants can be placed through incisions in the mouth to add volume to the cheeks. Fats can be transferred from the thighs or the abdomen to add lost volume. Finally, the cheek tissues can be lifted either through a lower eyelid incision or a hairline incision to recreate a more youthful and full cheek.
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The power of a mid-face lift and why it works
The following is my opinion. I have lectured on this very point to plastic surgeons at international conferences.
The MF lift is my favorite procedure due to its elegance and power in transforming the facial shape from aged deflation to curved youth. As we age,almost all of us lose facial fat. The pockets of fat in the face are not united, but rather separated by thin walls of collagen. As they go horizontally across our face in our youth, deflation results in the more vertical folds we see in age. High mid facial curves with a short lower eyelid vertical height is the characteristic of youth. The tightened flat cheeks and elongated lower eyelids of a face-lift that ignores the cheek lift is a sad sight to be hold!
So, the options for effective rejuvenation number 2:
1. Re-inflate each pocket of fat with a substance such as Sculptra, OR
2. If there is enough remaining fat in the fallen face, elevate the fat pads back to their original position through a Mid-Face lift.
Your question regards #2. I make incisions in the temporal (temple area) scalp and an incision inside the upper lip on either side of the mouth. Staying just on top of the mid face bones, the overlying soft tissue is re-suspended upward with sutures that dissolve in 6 months. The tissues heal to the bone in the elevated position and stay there until many years more of fat deflation occur.
My patients find this procedure to be not painful and extremely effective. The "downside" if there is one is that the cheeks swell creating a mildly "alien" appearance for a variable amount of time... usually less than 2 weeks. It may take up to a couple months before the patient feels comfortable with the results. By 3 months post-operatively, about 95% of my patients tell me it was the best procedure they have ever seen!
Midface lifting addresses the sagging present in your...
Midface lifting addresses the sagging present in your cheeks with aging. It can help improve your cheeks and lower eyelids, leaving you looking refreshed and younger.
Fat that is normally centered high over your cheekbones descends with age, giving a flat appearance to the face and heavy lines in the nasolabial area.
Any procedure that increases the volume in the cheek region can have the effect of lifting the midface, such as:
- Fat injections
Surgery to lift the midface produces the longest lasting effects because it actually takes the fallen tissues and puts them back where they belong. Recovery time for midface lifting can be several weeks with prolonged swelling and cheek numbness being the most worrisome problems.
Hope this helps!
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A midface lift addresses the soft tissues located over...
A midface lift addresses the soft tissues located over the cheek that tend to drop or descend with age. This lift can be performed in several ways, including endoscopically via incisions hidden behind the hairline in the scalp, directly through a standard facelift incision (in front of the ear) or directly through a lower eyelid incision.
This is different than a facelift, which often (but not always) refers to improving the contour and appearance of the neckline and jawline.
The key is to sit down with your surgeon and speak openly about which one of these operations will address your specific concerns, so that you're well-informed and that you and your surgeon are on the same page.
Hope that helps-- good luck!
Midface (Cheek) Lift
A midface lift, also called, midface suspension, meloplication, or SOOF lift (a less comprehensive procedure) elevates and tightens the skin and underlying cheek tissues. By elevating and tightening the cheek structures, the lower eyelid and cheek will have a more youthful, fuller appearance with reduction of under eye hollowness (tear trough deformity) and excess skin, and softening of the folds between the cheek and nose (nasolabial) folds.
The midface lift can be performed through incisions at:
1- the lateral canthus (outer corner of eyelids)
2- the front (transcutaneous) or back of the lower eyelid (transconjunctival)
3- the inside of the mouth behind the upper lip(buccal) or
4- the hairline (temporal area).
The approach to surgery will depend on the surgeon’s comfort level with a particular approach, the reason for the lift, and desired end result. In some cases, the surgeon may use a tiny camera called an endoscope to guide them through the surgery.
Once the cheek has been freed and elevated, several techniques are used to secure or anchor the cheek tissue to prevent it from sagging. Some surgeons will use suture material to suspend the cheek tissue while others utilize resorbable anchors, such as Endotine B or ST suspension devices.
The less comprehensive SOOF procedure, elevates and re-positions the tissue at the eyelid and cheek junction (under eye area) to give a smoother and supple appearance to this area. It is used in conjunction with lower eyelid blepharoplasty and during reconstructive procedures.
There are advantages and disadvantages to each approach, suspension technique and device. These should be discussed with the surgeon.
A Midface lift concentrates on correcting mid-face sag, which is the area between the lower eyelid and upper lip region. This is a form of minilift and is usually performed through lower eyelid incisions. A side benefit of this procedure is that it does diminish the nasolabial fold, creates a rejuvenated mid-face appearance and also results in some small improvement in the jowl area.
It is a good procedure for a man or woman who has early facial aging changes. It may also be successful for those of a more advanced age, but this would need to be individualized by a plastic surgeon who would tailor the procedure to the patient's specific anatomy.
A midfacelift addresses the lower eyes and cheeks
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:
Midface lift = Upper cheek lift
The midface is an essential component of an attractive face. With the aging process, the fatty tissue that normally drapes over the cheekbones can begin to sag with gravity. The result is less prominent cheekbones, and a droopy fold of skin and fat between the nose and the cheek (the nasolabial fold). The sagging cheek fat can also alter the appearance of the lower cheek. For example, bagginess of the lower eyelids often becomes more apparent after the fat of the upper cheek begins to sag. This in essence 'unveils' the bagginess of the lower lids, which have always been there. In addition to sagging of the skin and fat of the midface, there is also volume loss from the cheek with aging, due to loss of cheek fat and muscle.
A number of cheek lift or midface lift procedures may be performed either alone or in combination with other procedures. The goal is to reposition the sagging fat of the cheek over the cheekbone to restore the youthful fullness of the cheeks. The procedures include suture meloplication or percutaneous cheek lift, endoscopic cheek lift, subperiosteal cheek or midface lift, feather lift suture suspension, malar augmentation with lift, and SOOF lift.
Using minimally invasive cheek and midface lift techniques with limited incisions, the droopy cheek tissue can be lifted up over the cheekbone restoring the more prominent youthful contour, improving the tear trough and bagginess of the lower lids, and softening the undesirable cheek fold.
For more information and before and after pictures visit:
What is a Mid-face Lift?
The mid-face region roughly correlates with the area between the lower eyelid and the corner of the mouth. A mid-face lift, sometimes referred to as a cheek lift, can help to restore fullness to the mid-face by vertically repositioning the soft tissue of the cheek to a higher, more youthful position on the cheek bone. At the same time, lower eyelid appearance is often improved as the repositioned cheek tissue is more favorably redraped over the lower orbital rim, minimizing the unfavorable hollow appearance of the lower eye region. A well performed mid-face lift can be a powerful method for facial rejuvenation. Learn more about this procedure on our site.
In contrast, what are commonly referred to as a 'regular' facelift or mini face-lift are used to rejuvenate the lower face. The greatest impact of a facelift and mini face-lift are seen in the region of the jowels, marionette lines and neck. The traditional approach to this procedure is by way of facial incisions concealed around the ears. I hope that helps. Warm regards.