Endotine Midface Lift: Preventative or Corrective Procedure?

I'm in my 20s but am already beginning to notice the signs of sagging in my face. Unfortunately, I was genetically saddled with a lot of fat in my cheeks and a good portion of it is going down, down... So my question is, can an endotine midface lift be considered a preventative procedure as well as a corrective one? That is, if I have one performed now, will I have offset some of the aging I would otherwise accrue through my late 20s, etc.? (Side question: how many facelifts can one get in one's life and still look fairly normal/decent? For sure very few people get facelifts in their 20s, but since it's only a ribbon lift and it's not as invasive, I feel okay with getting one at this point. However, if this means I can't get more extensive facelifts in the future, then I would obviously opt to wait. Thanks so much!)

Doctor Answers 7

Don't do surgery too early

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Especially with Asian patients, elevation up and to the side of the face (the direction of pull with the Endotine) can cause increase in the distance between the cheeks, the intermalar distance. This can cause a flattened appearance to the face.

In general with plastic surgery, it is a bad idea to perform surgery for a "preventative" reason. Surgery has many minuses with it (scars, cost, potential complications or alteration in appearance) and should be done only when an actual problem is present, not to prevent one from developing.

Younger patients often benefit from hyaluronic acid fillers, in your case perhaps in the nasolabial folds.

Many patients, sometimes celebrities, do have plastic surgery frequently. This tends to become very expensive and the changes tend to be very minimal. For patients OK with that paradigm, it is acceptable to have relatively early plastic surgeries provided the doctor thinks that the benefits will outweigh the risks of the surgery. The burden on the surgeon in such a case is increased, since surgery is now being performed on a patient with a minimal problem. It is incumbent on the surgeon to provide a real service and benefit to the patient, not just perform the surgery because the patient thinks they need it.

It is not uncommon for patients who are very attentive to their appearance to have 3 or 4 skillfully performed facelifts in their lifetime.

"Just a ribbon lift" is not an accurate statement. Permanent material left in the face may cause real problems, as the many blogs on threadlifts on this website attest.

You should feel after your consultation that your doctor has your best interest in mind. Be careful with your health and your appearance!

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

You've heard "too little, too late"...

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

how about "too much, too early." Youngrace, you are a beautiful, young woman with no signs of facial aging. Additionally, you are obviously an intelligent, forward thinking individual. Too often in today's society too much emphasis is placed on staying youthful, which is ok, until it is taken to the extreme. Enjoy your twenties. You look great and cosmetic facial rejuvenation surgery should be the last thing on your mind right now.

Don't have Endotine Midface lift!

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I join in agreement with my colleagues in discouraging you from undergoing this procedure.

I have seen 10 year old children having the appearance of a "falling cheek", does that mean they should undergo a ribbon lift?

Any surgery carries risk. With that risk comes a judgement of whether the risks are worth the benefits. Clearly, we as professionals, concur that the risk (given the relatively minor problem you complain of) is not worth it. How would you feel if one cheek settled differently from the other? Would you be willing to undergo a revisionary procedure? None of us would rate your degree of aging as sufficient to merit surgical correction. Now the other part of this decision making process, we think you look great now but how much does it bother you?

If you find that this sufficently occupies your thoughts, you may want to consider a camouflage procedure such as a filler along the junction of the cheek and eyelid (the "tear trough") to try out the look.

In regards to your inquiry about slowing the aging process, this is speculation and I am not aware of any study that would support this concept.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Endotine facelift in 20's

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

First, in your 20's I doubt very highly that you need anything done.  WIth that said, I don't like the endotine facelifts. I don't think they last very long.

Steven Wallach, MD

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Best to wait

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

At age 20 you are too young to have any drooping in the face, and I would not recommend an Endotine Midface-lift. The Endotine is a dissolvable device. Most patients have one facelift in their 50s and maybe a second one in their 60s. Rarely do patients ever have more than three facelifts in their entire lifetime. Wait until you are at least into your late 40s before embarking on any cheek procedure.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Don't consider any procedure "only minor"

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}


Having a face procedure which is minimally invasive, such as an entotine, should not be taken lightly. However, based on your pictures, it may be helpful. One cannot tell for sure without examining you in person. As for the number of facelifts or facial procedures one can have during their lifetime is not a number set in stone. Just make sure that you are seeing someone who is qualified and has extensive training and experience in aesthetic surgery of the face. I hope you find this helpful.

Endotine Midface Lift: Corrective or Preventative?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your question. In general, it is a bad idea to perform surgery for "preventative" reasons. Surgery should be done only when an actual problem is present, not to prevent one from developing. It would probably be best for younger patients to use hyaluronic acid fillers, sometimes in and around the nasolabial folds.

Ramtin Kassir, MD
New York Facial Plastic Surgeon
4.7 out of 5 stars 180 reviews

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.