Mid face lift with lower bleph? (photos)

Your photos are showing typical features of the athletic person with minimal body fat. That gives your face  tired, gaunt look. There is no descend of muscles in the face and cheeks (we know it from long term studies on aging) it is mostly loss of fat content in multiple fat compartments of the face. To make it short, rather then lifting (which doesn't work very well for midface) fat grafting would be the most natural option to correct your "deformity". You should schedule a consult with a board certified plastic surgeon with good experience in fat grafting of the face and discuss your goals and options. Good luck.

First of all you are a very pretty woman. That is a good thing. You will do well with whatever you choose.  Second in the first photos you are smiling much more naturally and forcefully than in the more recent photo. When we smile we raise the cheeks. So that is part of the photo discrepancy.Third, I recommend you are conservative. You are young and things will continue to change. Fat in the face looks good. You don't have much fat anywhere it looks like. That is good for your overall health but can make you appear to age more quickly.   When we transfer fat to the face sometime we are camouflaging muscle thinning and skin aging along with actual facial fat volume changes. It is not only that the volume is decreased but the fat "pockets" (which are fat compartments separated by ligaments) has begun to fall and droop. So with transfer of fat or injection of filler we can correct this. For your lower lids, in my hands, I would recommend laser. You don't have the significant muscle and fat issues to warrant a blepharoplasty at this time from what I can tell from the photos.Hope this helps.Best of luck,DrC

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

The most helpful view is the non-smiling one, which shows very little volume loss under the eyes, almost no lower lid fullness, and good cheekbones/width. A little volume carefully placed in the under-eye area would be great. I would not recommend a midface lift and likely not a lower blepharoplasty. Hope that helps and best wishes, Dr. Donath 

Elevation of the midface endoscopically along with lower eyelid surgery can be a great way to reverse early signs of aging without  any visible signs of aging.  By elevating the malar fat pad (the cheek), and then elevating the lower eyelid muscle, a more youthful appearance is achieved.  Fat and extra skin from the lower eyelid can be removed it necessary.  elevation of the orbicularis muscle is an important component of this surgery providing a seemless lower eyelid and cheek junction

Thank you for your questions and sharing your photos. I don't recommend a mid face lift. I think long term fillers would be a great option for you. When you add volume to the cheeks that will give you a slight lift on its own. Best of luck!Dhaval M. Patel Double Board Certified Plastic Surgeon Hoffman Estates Barrington Oakbrook Chicago

Getting a fussy under eye filler service is absolutely the right choice for you.  The filler treatment must be done by the right injector.  The service will last about a year and it will be the right service for you for the next decade.  If you do go the route of invasive lower eyelid surgery, I urge you not to also have a cheek implant placed.  Please carefully think about your choices.  Many things can not be fully repaired.

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Given your age and pictures, I would highly recommend fillers or fat grafting or cheek implants rather than a midface lift.   Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their
results.   The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

You have the typical loss of facial volume seen with aging. The muscle is not the problem, it is shrinkage and descent of your facial fat pads. Filler will correct this.

I am not a big fan of the isolated mid face lift because of the many risks of the surgery.  I do them with facelifts but through a different approach. You are probably best served  with filler placement.