What are some Mid-facelift complications when done through mouth and temple?

This operations as originally described was a subperiosteal midfacelift. A small incision is made in the upper lip sulcus and the maxillas is exposed subperiosteally up to the zygoma. Another incision is made behind the hairline in the temple and endoscopic dissection is done on the deep temporal fascia down to the medial zygomatic arch. The exposure is joined between the upper and lower areas and sufficient dissection is done so that the midface tissues can be elevated with a suture from the lower midface deep tissue up to the deep temporal fascia. This suture is tied under tension. Care is taken to try to go around the two sensory serves that come out of the zygoma and the deep temporal fascia.  If care is taken not to go too lateral on the zygoma, it would be rare to injure the temporal branch of the facial nerve.However, traction on the infra-orbital nerve which is sensory to the upper lip is inevitable, and if this is excessive permanent numbness or discomfort can occur. Since the result depends on tension to lift the midface, there exists an unacceptableand unpredictable risk of problems with traction on the infraorbital nerve, in my opinion. Unless wide dissection is done to release the tissues from the periosteum, this technique does not give adequate lift, and with wide dissection, the nerve is subject to traction. For this reason I do not recommend this technique.Modifications of this technique exist, such as supraperiosteal and trans lower lid operations that are not subperiosteal and these may protect the infraorbital nerve better.Nowadays, it makes more sense to do a less invasive procedure for the lower face and neck and add fat grafts to support the infraorbital cheek area.

To me, the midface lift done through the temporal and oral approach doesn't give much improvement, so I don't perform it.  Although the risk are low, the results just aren't that great. The biggest risk of the procedure is injury to a nerve. I prefer to stick to simpler techniques that gave a good track record.

In our practice, we do not perform the mid face lift, rather we augment a flat cheek profile with cheek implants. When patient's need a face lift to lift the jowls and tight in the neck, then we perform a comprehensive lower face and neck lift. For many examples of  both cheek implants and facelifts, please see the link and the video below