How Safe is a Cheek Lift for Eyelid Correction?

The following is my opinion. I have lectured on this very point to plastic surgeons at international conferences.

The Mid-Face Cheek 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 behold! Having praised the procedure done correctly - there is nothing it will do for your upper eyelids.

So, the options for effective mid-face rejuvenation of the cheeks and lower eyelids 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.

Either way, the lower lids need to be addressed either with a resurfacing laser to shrink the skin, or a skin excision of the excess lower lid skin only.

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!

Laila, a cheeklift is designed to improve the apearance of the lower eyelid and the skin just below it in the upper cheek region.  It can tighten skin and minimize any bulging fat bags.  It may have a small effect on the nasolabial fold (smile crease), but it is subtle.  It will have no effect on the upper eyelid skin excess, but upper lid blepharoplasty is often combined with a lower lid cheeklift in the same operation.  The operation can be safely performed in the appropriate patient.  Your surgeon should know what to look for on physical exam and must be experienced in performing cheeklifts to avoid common pitfalls and complications.

The main indications for a cheek lift are to improve the grooves from the nose to the corner of the mouth, give the appearance of higher cheek bones , fill the grooves at the bottom of the lower eyelids, and improve the contour of the lower eyelid margin. Upper eyelid surgery can be done during the same procedure, but the cheek lift will do nothing for the upper lids.

 A cheek lift can recruit volume back into the lower lids and make them look somewhat better but it has absolutely no role in upper lid rejuvenation.  This requires an upper blepharoplasty and occasionally a browlift.

A cheek lift (also referred to as midface lift) treats the area from the lower eyelid down the cheek to about the level of the bottom of the nose. It does not affect the upper eyelids. Perhaps your surgeon is also proposing some form of eyelid surgery as well? You should clarify the expectations of the surgery with him before the surgery to make sure you are both on the same page.

Unfortunatley, in order to make a recommendation of what I think the best procedure is for you, I would need to see you. A few of the many possibey upper eyelid solutions are eyelid surgery, eyelid ptosis repair, browlift, fat transfer, or injectable fillers.