What is a subperiosteal mid facelift?

Subperiosteal mid-face lifts elevate the facial tissue by lifting the periosteum off the bone of the cheek and lifting all of  the tissue as one unit to a higher level. It is a reasonable option for men or women with cheeks that have sagged, but they don't have a lot of jowling or loose skin in the neck. Potential problems with subperiosteal lifts include prolonged swellling, recurrent sagging if the overlying tissues aren't firm enough to be pulled up with the periosteum, nerve injury, and pulling downwards on the lower lids.

The periosteum is the thin layer of facia that covers bone, in this case the cheek bone (zygoma). A subperiostel lift is below the periosteum and when this layer is lifted so is all of the superficial soft tissue. This is a more invasive procedure than most of the newer technique and results in prolonged and extensive swelling. I no longer use this technique in my practice for these reasons.#midfacelift

This involves lifting the malar soft tissues (cheekbone) from the bone and pulling it up with sutures to the temple region.  This can be done via the lower eyelids or via the mouth.  A deep plane facelift lifts the skin and SMAS which is the tissue under the skin, without reaching the bone.  The recovery is much longer for the subperiosteal lift due to significant swelling afterwards.  Another option for lifting the midface is a high SMAS facelift.  In my opinion it is just as effective with a quicker recovery and a more natural look.  

In this operation elevation of the soft tissues of the face is performed through the inside of the lower lid and deep to the muscles and soft tissues of the face. This is an operation with a well-deserved reputation for significant face in eyelid distortion. It should only be performed by someone who is very experienced in the technique. Facial rejuvenation in the periorbital area can be done by fillers. A conventional facelift accomplishes the same thing as well as restoring youth to the neck.

A subperiosteal facelift is a type of facelift procedure that lifts the mid face tissues by performing a dissection on top of the bone of the mid face. This procedure is usually performed through an intra-oral approach ( through the mouth) and through incisions in the lower lids ( eyelid lift /  blepharoplasty incisions). It also can be done trough an endoscopic approach through incisions in the hair bearing scalp.Since the "lifting" capacity of a subperiosteal facelift is not as powerful as other techniques that involve the traditional facelift incisions ( scars in front of the ears), this type of facelift is usually recommended to young patients ( 40s) who have minimal skin laxity but descend of the mid face soft tissues, and don't want /it is not recommended traditional facelift scars.

Thank you for the great question.  A subperisoteal midface lift, or as some would describe in marketing terms as an "endoscopic facelift", is an approach which calls for elevation of the tough periosteum from the maxilla in an attempt to raise the cheeks.  The problems with this approach are 1) when performed conservatively, much of the perceived result departs when the swelling is gone,  2) when performed aggressively leads to a very stylistic or "done" look, 3)  the aging of the midface is not well addressed by lifting and repositioning the periosteum, and 4) this approach does nothing for the aging neck. This approach can work well in carefully selected patients, but is by no means an ubiquitous approach to facial rejuvenation.

Subperiosteal face
lift is a technique that develop a plane under the periosteon which is a tissue
that covers the bone. That technique was
in vogue about 15 years ago but for the most part is abandon because does’ not
add much advantage to the results and there are other
techniques that offer better results

Subperiosteal means the tissue is elevated at the level of the bone. Deep plane means it is done above the bone but below the SMAS. Swelling is greater and lasts longer the deeper you go. 

Subperiosteal implants are used in the lower jaw for people who have no lower teeth and not enough bone for the root form dental implants. Subperiosteal implants are metal frames put underneath the gums, on top of the jawbone, with metal pieces that stick up through the gums to attach a bridge or crowns. This is often done in a two-part surgery.

 In our practice, we do not recommend a sub-periosteal midface lift. The mid face does not descend with the gravitational forces of aging, rather it shrink-wraps with loss of volume. Because of this, we recommend cheek implants to restore lost volume  to the midface. Cheek implants are manufactured in a variety of sizes and shapes, are inserted through intra-oral approach in the sub-periosteal plane directly over the bone. A facelift accomplishes  tightening loose facial and neck skin, lifting the jowls, tightening loose facial and neck muscles, and removal of fatty deposits in the neck. For many examples of  cheek implants and facelifts, please see the link and the video below