Will a endoscopic mid face lift, fat transfer and lower eyelid skin pinch help me correct hollowing and crows feet? (photo)

Question

Hello! I'm 36 yo. I have hollowing under my eyes and the beginning stages of crows feet. I can see the separation of fat pads in my paper face; it seems as though my cheeks have "fallen". I'm interested in a minimally invasive endoscopic mid face lift with a skin pinch and fat grafting to eyes and temples. Do you think this is best course to address my issues?

Mark G. Albert, MD, FACS · Answer

Hello,
Thank you for your question. You are right on target with you assessment. Based on your photos, a mid-face lift is a great option (endoscopic or small temporal incision in hair without scope). This can be done wide awake using local anesthesia and oral medications to help you relax. Patients do incredibly well with this and it avoids the side effects of general anesthesia.
Fat grafting to eyes/temples and skin pinch can also all be done awake.
Mark G. Albert, M.D., F.A.C.S.New York, NY

Alan Gonzalez, MD, FACS · Answer

Hello @Juno555, thank you for your question. I would recommend non-surgical treatments and the use of technology that provides solutions for volumizing your cheeks and butolinum toxin for crow's feet. Your skin is too young for a minimal facelift. Lower eyelid surgery is very delicate and requires a very precise indication because when you make the cut below, the ligament that holds the eye to be as almond-shaped as we all like. It is a ligament that has a certain capacity to resist tension. As we reduce the amount of skin in the lower eyelid area, the expression may change and will not correct crow`s feet. In my opinion fat grafting is too unpredictable for the face; it can migrate, it may not stick and that generates asymetries. Fillers are in my opinion a better option so you do not have issues in the long run. Whenever considering any surgical procedure such as a facelift or eyelid surgery, it’s important to consult with an experienced plastic surgeon who can explain all options thoroughly to make informed decisions based on your needs goals and what can be accomplished. Best wishes! Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science  Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery Member (SCCP)

Gianfranco Frojo, MD · Answer

I would recommend a lower eyelid blepharoplasty with fat grafting. This will provide volume to the area under the eyes and help redistribute where the volume/fullness should be. I personally recommend a normal facelift with normal incisions around the ear to optimize visualization and tissue tightening/re-suspension. Sometimes "minimally invasive" or "mini" techniques under-deliver results for patients unless performed by an incredibly experienced plastic surgeon.

Jeffrey Lisiecki, MD · Answer

I see what you are describing, but you don't look like a candidate for an endoscopic midface lift, and I would not advise a skin pinch for your lower eyelids based on the photograph provided.  Your concerns can likely be improved significantly with just some fat transfer, but in-person evaluation will be very helpful in making the right diagnosis and plan for you.

Stephen Prendiville, MD · Answer

Given the lack of anything to address with surgery, I recommend that you have a nice vacation and enjoy your youthful looks.  There will come a time when such procedures are applicable, but no ethical Facial Plastic Surgeon should do anything at this time.

Kenneth D. Steinsapir, MD · Answer

Give your minimal issues, the surgery you have described will profoundly harm you. Fat grafting is a terrible idea for this location whether it is nonofat, microfat, or whatever fancy name a surgeon wants to call it. Grafted fat is like injecting scar tissue. It gums up the wonderful plans that need to glide over each other. There is no such thing as "minimally invasive endoscopic mid face lift. The descriptor "minimal" is used to lull you into think that no harm will result from having the surgery. That is just not the case. The skin pinch will pull your eyelid down. When I look at you, I do wonder if you have had hyaluronic fillers in your cheek in the past. If that is the case, I would recommend removing those fillers and consider having a very precise filler treatment in the under eye circles. These are fussy services and often well meaning injectors use the the wrong filler product in this area. Restylane is the best product in my opinion. So-called smooth fillers are far too runny for this location.

Zoran Potparic, MD · Answer

Based on this photo, it does not look that you have reason for any kind of midface lift. However, you would benefit of adding volume by means of fat grafting of the cheeks, temples. Only on the basis of in person consultation and discussion about your expectations one could decide whether tranconjuctival lower ble[haroplasty (no skin removal) would help with moderate tear trough defomity? Hope this helps.

Ronald J. Edelson, MD · Answer

The endoscopic midface lift will at best do very little. At worst however, combined with removing skin you would be a setup for the lower lid pulling down. Seen it many times. Fat transfer is also a terrible procedure. From your photos I advise against surgery

William Portuese, MD · Answer

From the one photograph presented, you do not need any surgical procedures whatsoever. In our practice we do not perform a mid facelift and fat injections for a long variety of reasons. At age 36, you do not need a pinch of the lower lid skin. Consider Botox for your crows feet.

Darryl J. Blinski, MD · Answer

Your 1 posted photo appears as minimal aging. I might offer just mini face lift with SMAS plication and nano fat grafting to tear troughs and temple hollow. Fee$10, 000. Best to virtual consult with....

Will a endoscopic mid face lift, fat transfer and lower eyelid skin pinch help me correct hollowing and crows feet? (photo)

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