How effective is a mid facelift done with under eye incisions that also fix undereye hollows?

This technique is not effective in my opinion for getting the best results of a facelift and rejuvenating the eyes. The eyelid skin is very different from the mid face structures and they are two separate areas that require different techniques for optimal results. In addition, you can cause problems with scarring under the eyes that can cause chronic dry eyes, etc. #Midfacelift #PlasticSurgery #Facelift #Blepharoplasty 

What you are talking about is fairly risky and not something that I generally recommend. I would advise you to find a board certified plastic surgeon in your area and speak with him or her about the best options for addressing your mid-face/eye issues. Best, Dr. Nazarian

Midface lifts done via a lower eyelid incisions are risky in that they can cause lower lid scarring that can result in lid lag or ectropion.   Midface lifts can also be done via a facelift incision that spares any scarring around the lower eyelid.  Lower eyelid hollows are corrected by the midface lift and if necessary additional fat grafting in the area.  

Strategies for management of volume deficiency near the lower lids would include fillers or surgery. Conventional facelift affords access to the area. A midface lift breaches the connective tissue barrier between the lower lids and cheek. It's careful reestablishment is necessary to prevent lower eyelid position problems. Make certain you understand this.

There are so many variables here, and no pictures, so it is hard to comment.   If you are hollow, then you will need either fat transposition which is usually done from inside the lid, or fat transfer.  Some surgeons like to do a midface lift through the lower  lid.  YOu have to be very careful that this is done correctly or you could get an ectropion post-op.  Get a couple of opinions before you do anything.  See an oculoplastic surgeon since they specialize in the lids.    

The primary goal of a dedicated midface lift is to rejuvenate the infraorbital and malar region..  There are several techniques to do this.  One technique is via an incision right under the lash line as you describe.  This can also be done via a transconjujuctival incision.  The problem with both of these incisions is that the weight of the facial structures are being held by the eyelid structures.The lower eyelid is not a very strong structure and has risk of ectropion even if it is not supporting the entire midface.Therefore, I recommend a temporal incision to do a midface lift and a separate incision to address eyelid related issues (herniated fat, excess skin, etc)

Because this operation has a high complication rate I generally recommend against it.  The lower eyelid structure is not made to support the weight of the cheek skin, and although the technique has been described to carry the weight to surrounding structures.  These sutures frequently are not supportive enough and the end result is ectropion and dry eyes.  Because there is a natural tendency for lower eyelid sag as we age due to eyelid stretching this can have implications for the future comfort and safety of the patient.

Several factors can contribute to an aged
appearance of the lower eyelid -- descent of the cheek fat, prolapse of the fat
around the eye, excess skin, etc. 
As
the fat of the cheek descends it can leave the bony rim of the eye socket more
apparent through the relatively thin skin of the lower eyelid, and cause
deflation and abnormal shadowing that makes you appear older or tired. In most
this occurs with age but it can be genetic (the so-called "negative
vector" cheek).
This is correctable in a number of ways, including with a surgery called a lower blepharoplasty. Through an incision just below the eyelashes the
fat of the lower eyelid & upper cheek may be mobilized and repositioned to
add volume to the lower eyelid and help the dark circles fade. Though it should
not be considered a permanent solution, this approach should give you a durable
improvement over 15 years or more (before you start to see the same issues
appear again). You can see photos of patients who had this procedure on my
profile page.
This procedure should not be confused with a midface lift, which is typically performed through different approaches for different cosmetic concerns. These distinctions need to be clarified with your surgeon prior to surgery to ensure that your expectations are met to the fullest of his or her ability, with the surgery that is most appropriate.

As always, obtain a consultation with a
Board-certified Facial Plastic Surgeon or General Plastic surgeon to get a
fully-informed recommendation from a surgeon who is able to examine you. Best wishes!  Harry V. Wright MD, Sarasota, Florida

I do not perform facelifts via under eye incisions as the complication rate from this was too high. Thanks

That procedure can be very effective. I would say it depends upon your goals and what you have to start with. There are less invasive and quicker methods available as well. I would talk to a couple surgeons in your area about  your goals and see what kind of recommendation.Good luck!