Does a mid-face (cheek) lift also take care of lower eyebags?

Question

I have 2 problem areas - sagging cheeks which can be fixed with a mid-face (cheek) lift and puffy eye bags. I am wondering, does a mid-face (cheek) lift also take care of lower eyebags or does it require 2 separate surgeries? And if it requires 2 separate surgeries, do the surgeries have to be done on the same day? If not, are the results any better or worse if done over a couple of years? e.g. Due to finances, I would do the eye bag surgery 1st, then 2 years later, do the mid-face (cheek) lift?

Andrew Turk, MD, FACS · Answer

The eyelid bags are due to laxity of the lower eyelid skin, muscle and fatty deposits.  The descent of the cheeks gives a deflated , saggy midface and jowls with deep nasolabial folds. Both of these changes in facial aging can be fixed at the same surgery. A lower blepharoplasty and vertical midface lift  with fat grafts would be the plan for surgery.However, the lower eyelid tightening or blepharoplasty can be performed first under local anesthesia .  There would be less downtime in your recovery.  It would address the puffiness, which is  caused by fatty tissue that needs to be removed or repositioned to smooth out the eyelid skin.The vertical midface lift and fat grafts can be performed as a second surgery in the near future.

Jeffrey Umansky, MD · Answer

A mid-face lift through the lower eyelid approach can be an effective way to treat a sagging cheek and bulging eyelid fat. Without photos, it is difficult to tell if you are a candidate. I recommend setting up a consultation with a board-certified plastic surgeon to discuss the best treatment plan to fit your needs. Best of luck!

Ali Riza Öreroglu, MD · Answer

A facelift procedure targets the excess skin in the lower half of the face while providing a tightening/lifting effect for the remaining skin and deeper tissues. Facelift procedures alone do not target the eyelids. Blepharoplasty procedures target the eyelids and the bagging under the eyes. However, facelifts are often combined with eyelids surgeries within the same session with very good outcomes.Hope this helps,Ali Rıza Öreroğlu, MD FEBOPRASEuropean and Turkish Board Certified Aesthetic, Plastic and Reconstructive SurgeonIstanbul, Turkey

Juan Carlos Fuentes, MD · Answer

Some photos are important to evaluate your case. The puffiness on the lower eyelids usually requires a lower eyelid blepharoplasty, but to correct the midface, there are many techniques that can improve that area. Most of the patients will benefit from 2 different procedures, that can be done the same day, t correct those problems.

Thomas Trevisani, MD · Answer

Without photos- it's difficult to give the best answer. Generally speaking, a facelift and blepharoplasty can be performed at the same time- if indicated. However, if your eyes are the priority - then you can stage your procedures, and have blepharoplasty first

Ronald J. Edelson, MD · Answer

It would help to see photos.  However I am not at all a believer in the whole concept of the midface lift.  It is really oversold and a ccomplishes virtually nothing in my opinion.  I agree that you would probably be just as well off simply having your lower lids done if that is what bothers you.

Gregory S. Keller, MD, FACS · Answer

With an endotine cheek lift, the incision is usually made in the temple, so that there is no need for a visible eyelid incision for bags.  The blepharoplasty with “fat repositioning” (repositioning the fat in the eyelid bags into the cheek) can be performed through an incision in the conjunctiva, so there are no visible incisions.  The two procedures are actually complimentary to each other in filling out the cheek and enhancing the lower eyelid for a natural balanced look. They are best done at the same time to get the maximum effect.
The problem that you have is termed: “pot belly (the eyelid bags) over “fallen jeans” (the fallen cheeks). So correcting both makes both the eye and the cheek (termed “periorbital area”) look better.

Michael P. Morrissette, DDS, FACS · Answer

I like to look at this as two separate problems. If your midface volume descent is moderate, then a separate midface lift procedure will re-position the cheek in a more superior position that is not quite vertical. For isolated midface lifts, I like to use Midface endotines. The lower puffy eyebag problem is best treated by a lower blepharoplasty procedure through a transconjunctival incision. If there is excess skin, then a pinch blepharoplasty can be performed.

Toby Mayer, MD · Answer

Lower blepharoplasty with or without midface Lift. Both can be done thru an eyelid incision and you won’t have to separate them. You may not need a full cheeklift and an examination is needed to determine that. See a very experienced surgeon who does natural eyes.

John J. Martin, Jr., MD · Answer

The mid-face lift will not improve the lower lid fat pads.  You will need to do a surgery to address those.  Prominent fat pads are usually more aging than cheek laxity, so fixing the eyelids first if you want to split the surgeries is usually a good idea as it will be more rejuvenating.