Endoscopic or Traditional Mid Face Lift for Cheek Lifting?

I am 30 years old. I have sagging cheeks (not too much), hollow eyes. I decided to have endoscopic Midfacelift. One of the dr said to me, endoscopic mid face lift is not very successful, because face has not enough space to perform endoscopic procedure.

He believes that, with endoscopic surgery, there can not be much improvement about sagging mouth corners etc,(maybe he has a little knowledge or experience about endoscopic mid-lift.)

What do you think? For optimum results, must I have endoscopic or classical mid face lift? Mostly Dr.s dont advice to me classical Cheek lift, but why?

Doctor Answers 13

There is no such thing as a classic midface lift

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When we say cheek lift, we generally mean a facelift not a midface lift. There are a number of midface procedures done through the open facelift. They are disasterous for someone your age. Virtually all of the involve lift the orbicularis oculi off the zygoma with causes nerve injury to the orbicularis oculi muscle of the lower eyelid. Then there are a number of midface procedures done through the temple. The risk here is that again the nerves supplying the orbicularis oculi can be harmed. Also the deep fat overlying the zygoma and extending into the temple can be damaged by the surgical dissection. The effect is loss of volume in the temple and over the top of the zygoma. This makes it look like some took a bit out of the side of the face.

Yes it is possible to have these procedures with less damage but I do not seem so many results like that. Also the purpose of the procedure is to moblilize the cheek (malar fat) and pull it up toward the temple. Well it turns out that it is not suppose to go there. The result is more than a little unnatural. Can these various procedure be done endoscopically. The answer is sure. However using a smaller hole to get the job done does not necessarily make the surgery better, it just makes it harder to perform.

For someone like yourself who is 30 with under eye hollowing, the best answer to date has been filling under the eyes with Restylane.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Endoscopic cheeklift

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at your age, if in fact you have displacement of the cheek pad, it can be repositioned using either technique. The endoscopic approach does not involve and skin removal and at your age, there is likely no skin that needs to be removed, so the endoscopic approach for you might be  a viable option.

Endoscopic lift or traditional mid-face lift

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In younger patients like yourself with similar complaints I do an endoscopic lift with mid face suspension. Using a small scope designed especially for this procedure, the surgeon lifts the facial tissues away from their attachments. The entire facial unit of skin, muscle and soft tissue is then lifted like a mask upward and laterally. This technique allows the entire face to be restored to it's early position before the aging process took place. The results give a natural look reminiscent of the patients earlier photos. Without preoperative photographs it is difficult to determine what procedure is best for you. If you would like to send some photographs over to my site listed below I would be happy to further assist you. Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 214 reviews

What is the "best" midface lift!

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Over the past 30 years we have developed several types of "minface" or cheeklifts. There are two basic types: 1. Thru the temple 2. Thru the eyelid

Which of these is right for your situation is the key. Some patients only need a small amount of lift and have a normal lower lid without extra skin. I use a temple incision and endotine for this group. However, most have excess skin and or fat in the lower lids and in these patients I use a lid incision with a different endotine that is fixed to the bone. Excess skin and or fat is removed at the same time.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Endoscopic versus traditional nmidface lfit

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I would agree with your statemet that the success can be related to the experience of the surgeon. However, there are many other factors including the method of fixation. In general, with the traditional approach, more rigid fixation is possible and therefore it tends to be easier to achiev a longer lasting result.

Midface Lift

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An endoscopic mid-face lift is the right procedure for a droopy midface. The entire cheek and soft tissue of the midface must be lifted from the cheek bone and lifted up and outwards. The tissue is then sutured to the temporalis muscle in the temple area.

If your droopiness is in the lower face then a lower facelift would be more appropriate.


Dr. S.

Variations on mid-face lift

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I am not sure what you mean by a "traditional" mid-face lift since there are so many different approaches. One of the early signs of aging is descent of the fat pad in the cheeks, with skin laxity coming later. The idea of the endoscopic approach is to reshape the cheek by lifting the fat pad without tugging on the skin. There are ways of doing this without the endoscope, though my vote would be for that technique in a young person like you. Alternatively, some people do very well with something simple like fat injections or dermal fillers (Restylane, Juvederm).

Endoscopic or Traditional MidFace lift

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Thank you for your question. Endoscopic facelifts, though not being as mainstream as open surgery, are minimally invasive procedures which presents many advantages to younger people who are not in need of a major surgery. It has a very limited effect on the neck and jowl region, but allows patients to have a lower risk of potential nerve damage and is very effective in dealing with minor facial deformities such as cheek sagging. It cannot, however, be used to perform neck lifts or major operations which would normally require a facelift procedure. Therefore, for people who are in need of a facelift but do not require or want the invasiveness of open surgery, endoscopic surgery is a good option. 

Ramtin Kassir, MD
New York Facial Plastic Surgeon
4.7 out of 5 stars 155 reviews

The answer to fuller cheeks

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If it is volume you want, then use fat grafting.  It is safe and effective, with minimal incisions,  and will look very natural.  This can be combined with a mini face lift for further rejuvenation. 

Midface lift versus fillers in young person

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I prefer to treat the midface area with volumization - adding fat, cheek implant or fillers to the area - rather than surgical manipulation via midface lifting techniques.  I have performed endoscopic and traditional midface lifting techniques in the past but found that the results from adding volume to the area are just as good or better and with less trauma.  The fact that they can be reversible is an added safety feature as well.  My suggestion would be to avoid a midface lift.

Douglas M. Stevens, MD
Fort Myers Facial Plastic Surgeon

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.