Mid-face, skin removal only. Any suggestions?

hi. i am 43 and considering a mid-face lift. i have a very small face and feel fillers will make my cheeks too big. additionally, i would like a procedure with more permanent results than fillers. i have about 3/16" excess skin in the cheek area after a 10 lb weight loss. is it possible to just get the excess skin removed?if this is possible, can the procedure be performed under local anesthesia? Thank you.

Doctor Answers 13

Types of Facelifts

Without an exam or even photos it would be almost impossible to give you the best opinion.
See the below link for more information

Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

10 pound weight loss and sagging skin

It is not uncommon to have sagging skin after weight loss.  If you have reached your desired weight you can benefit from many procedures.  If you do not desire filler you may benefit from a lift.  Usually the excess skin involves the entire face, so an isolated cheek lift may not benefit you.

I recommend seeking additional advice from a Specialist in your area.

The type of anesthesia depends on your Specialist and local anesthesia may be an option.

Ernest Robinson, MD
Aliso Viejo Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Mid-face, skin removal only. Any suggestions?

Skin only mid face lift results are always disappointing as the skin tends sag again. SMAS plication at a minimum is usually required.

Mid-face, skin removal only. Any suggestions?

Skin-flap only facelift can be performed under local anesthesia. The skin, however, stretches by its very nature and the results of a skin-only excision will not last. In fact the results do not last much longer than do most fillers. This is an important point because you note above that you would like a procedure with "more permanent results". 

Find a Board-Certified Facial Plastic or General Plastic Surgeon who has experience with facelifting and have a frank discussion about what your expectations are, what your risk tolerance it, and what results the surgeon feels is reasonable to achieve under local anesthesia.

Best wishes!  Harry V. Wright MD, Sarasota, Florida

Harry V. Wright, MD
Sarasota Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews


Yes, It may well be that a Mini-Facelift will work for you. You will need to be evaluated by a board certified plastic surgeon and at that time you can discuss facelift options and anesthetic options.

William H. Gorman, MD
Austin Plastic Surgeon
4.1 out of 5 stars 20 reviews

Mini face lift is good option

I have added a link that might be helpful...

Hi ptamom2.  It is difficult to say for certain without photos and in person examination, but yes, a mini lift may be a good option.  Since skin is elastic, you should expect some relaxation with time if your surgeon doesn't lift the underlying tissues.  Keep in mind, that minor skin excess can be treated nonsurgically with skin tightening devices. Also, fillers can be used as an adjunct to improve areas that are not part of the lift-the lips, lines around the mouth, hollows of the eyes, etc.  Be sure to seek consultation with an ABPS certified PS for a thorough evaluation and review of your options.  Best wishes,

Vaishali B. Doolabh, MD, FACS
Jacksonville Plastic Surgeon
4.9 out of 5 stars 33 reviews

Yes that is sometimes called a mini-lift

Yes, it sounds like you will be happy with relatively minimal change as long as it will last.  A mini-lift in the office will remove skin only and tighten things a bit for you.  I will caution you though, if you have a small face, you will age more quickly in the future without re-volumizing your face.  Much of why we get jowling and loose neck skin is that we lose fat and bone in the face and then nothing is holding the skin up and it falls to the lower face.  Volumizing the upper face creates a more youthful heart shape and holds the skin up.  The reason many Asians age so well is that they tend to have large skulls which keeps the skin stretched taught and held in place.  So, mini-lift can help but you should consider filler or fat-grafting (which can be permanent) to prevent premature aging moving forward.  

Garrett Griffin, MD
Minneapolis Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Concept Facelift under Local Anaesthetic

Thank you very much for your question.  Ptamon2 without pictures or physical assessment of your face it is hard to advise which procedures maybe needed to achievable the results you are looking for.  I have many patients travelling from a distance to have my Concept Facelift procedure, therefore very popular.  My innovation procedure combines the latest surgical techniques with the use of local anaesthetic to dramatically reduce the risks associated with traditional facelifts.  This significantly reduces the bruising and downtime of your recovery, from months to a matter of days.

The benefits of local anaesthetic Concept Facelift are: 

  • Minimally invasive as it is a short scar facelift
  • There is minimal bruising and swelling, especially when compared to traditional facelifts
  • As the procedure is performed under local anaesthetic, you can go straight home following the procedure
  • Full recovery in a matter of days rather than months
  • Significantly less risk than Facelifts performed under general anaesthetic
  • Fresh, youthful and long lasting results

A lot of our patients will combine this facelift procedure with others as well to ensure their overall result expectations are achieved.  This could be eyelid surgery, dermal cheek fillers, lip implants, neck lift.  This gives patients an overall natural and youthful look.  Please do visits a plastic surgeon for a one to one consultation so they can assess you and you can discuss desired results, see before and after pictures of past patients and ask many questions you may have.

Best wishes with your future procedure 

I am 43 and considering a mid-face lit and can the procedure be performed under local anesthesia?

 Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts. Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin. Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits:

  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face. Non smiling photos of your face from the front and side would help in the evaluation.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Mid-face, skin removal only. Any suggestions?

Without the benefit of physical exam, and at least a good set of photos- it's difficult to provide the best answer to your question. Generally speaking, mid face and neck improvement can be achieved with a neck and check lift. These procedures will essentially stop the clock on the aging process and hopefully give you the improvement that you seek. Provided you are healthy and the surgery is not a major health risk to you- you should have a reasonable expectation of a good result. Hope this helps

Thomas Trevisani, Sr., MD
Orlando Plastic Surgeon
4.9 out of 5 stars 63 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.