Endotine Mid Face Lift- What Can I Expect in Terms of Length of Time Bruising Swelling?

I am considering the endotine mid face lift. The surgeon's website is quite honest saying "considerable" swelling and bruising. I went to another ps who is the other major player in my cosmepolitan area and he said that his patients are able to go out socially without evidence of surgery in 7 - 12 days if they use concealer. He said he used a glue that eliminated bleeding. That made me wonder if the other one didn't use the glue or if it was just a different method.

Doctor Answers 13

The Idea Is Attractive But The Details Get A Bit Sticky

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The "glue" which the second surgeon referenced is most likely fibrin glue. Fibrin glue is a mixture of fibrinogen (human) and thrombin (bovine).  Thrombin is the enzyme that catalyzes the conversion of fibrinogen to fibrin monomers, creating a fibrin clot. Clinically, it is most commonly used in ophthalmologic surgery, where it is applied in very small quantities directly to promote the adherence of small, delicate structures.

Now, returning to the midface lift, the degree of effective elevation of the midface is in large part a function of the extent and thoroughness of the release of the ligaments and structures tethering the soft tissues of the midface.  This necessitates a wide and complete dissection in the midface to achieve free upward movement of the soft tissues.

The postoperative swelling that the first surgeon describes in his website is a function of the necessary extent of this dissection in the midface to achieve a complete release of the soft tissues. Seven to twelve days sounds like a very realistic estimation of the time that must elapse after a midface lift of this sort before one is ready to go out in public, although it must be added that there will still be some degree of swelling present, even after the twelve day mark. 

The idea that squirting some tissue glue into the surgical field will appreciably decrease the degree of postoperative swelling seems hopeful but misinformed.  Again, the field of dissection in a properly performed midface lift should be quite broad. How can the surgeon insure that the tissue glue is thoroughly and evenly spread throughout the surgical field by squirting it through the small access incisions in the scalp and gingivobuccal sulcus (assuming he even uses both access sites)?

What volume of fibrin glue is he is using? The most commonly used brand of fibrin glue is rather expensive:  about $660/10cc syringe.  To use an amount sufficient to have any possibility of effect would appreciably raise the cost of the surgery, again with the problem of how to ensure that it is being distributed evenly and in the appropriate areas, and without any clinical studies that demonstrate it to be effective when used in this way.  

Most of the swelling from an effective midface lift is from postoperative inflammation of the soft tissues of the midface following a thorough surgical release to allow their free upward movement prior to endotine fixation.  The intraoperative application of tissue glue does not address this. However, a less thorough surgical release of the soft tissues would probably yield less postoperative swelling, but also a less effective elevation of the midface.   


Los Angeles Plastic Surgeon
4.6 out of 5 stars 49 reviews

Endotine Mid Face Lift- What Can I Expect in Terms of Length of Time Bruising Swelling?

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Endotine is just the way to hold up the tissues.  Sutures can be used as well.  What causes the swelling is the actual dissection of the tissue to be elevated. I have never seen anyone use glue for a midface lift.  It is usually done with a traditional facelift under the skin flap.  In my opinion, I do see more swelling from my midface lift patients than the traditional facelift patients.

Rigo Mendoza, MD
Tampa Plastic Surgeon
4.4 out of 5 stars 40 reviews

Endocrine Midfacelift and swelling

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I will give you my experience with the Endotine Midfacelift:  I did a lot of them and no longer do them or recommend them mostly because the results are marginal at best and not long lasting.  Swelling was never a major issue and is usually gone by 10 days or so with or without glue.  The use of glue in a Midfacelift is not all that beneficial or necessary.  In majority of patients that are considering a Midfacelift, a regular SMAS facelift with fat transfer to the eye/cheek are is a better option.

Recovery after Endotine Midface Lift

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In theory, the endotine device allows for a midface lift to be done in a less invasive manner than traditional temporal or cranial suspension methods that use a lower blepharoplasty incision to perform it. If it is done in isolation that way then the amount of swelling should be socially acceptable in about 10 days with minimal bruising. But it depends on what else may be done in and around the eye/midface area which could make the swelling and bruising more prolonged.

Endotine Mid Face Lift- What Can I Expect in Terms of Length of Time Bruising Swelling?

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Dear Curious,

Thank you for your question.  Endotine is a fixation technique, not a lifting technique.  The swelling comes from the surgery, not the type of fixation.  In general, just about any facelift looks presentable in 7-12 days, glue or not.

Best Wishes,

Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 42 reviews

Endotine lift

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Most facelifts have a downtime of 7-10 days regardless of the technique used. This should allow the patients time for the bruising to disappear.The endotine is just another technology, and it may not affect the amount of recovery time.All the best

Endotine mid-face lift

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  I don't think it is the endotine or the glue which will determine how swollen you will get after this procedure.  It is the dissection itself.  Also, some doctors exaggerate the speed of the recovery of their patients to help sell themselves, so please be careful.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 reviews

Endotine Mid face lift-What Can I Expect in Terms of Length of Time Bruising Swelling?

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Not everybody is a candidate for an Endotine Midface Lift.  Usually younger patients with droopiness of the midface, but not much of an excess kin is a perfect candidate.  The dissection usually in this procedure is a deep-plane dissection.  There will be some bruising and swelling, but it is considerably lesser than the regular face lift, but also the result is not as dramatic as the regular face.

Recovery from midface lift

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The original surgeon is correct in that swelling (and numbness) will last for at least 3 weeks or longer, but may not be that noticeable to others after about 2 weeks. Using tissue sealants does not improve this significantly in my experience.

Harrison C. Putman III, MD
Peoria Facial Plastic Surgeon
4.7 out of 5 stars 13 reviews

Face lift

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Many times these end of being a very temporary solution and dissapointing the patient. Find a surgeon who is proven to deliver the very best results. We have an amazing team here at the Boriscosmetic Center. If you would like to have a virtual consultation please contact us right away.   

George T. Boris, MD, FRCS - Account Suspended
Los Angeles 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.