Spacer graft for lower eyelid reconstruction
For severe case of ectropion, a lower eyelid spacer graft is often necessary. We prefer a chondromucsal graft (less painful than a palatal graft) when this is necessary; we have published this technique.
For mild to moderate cases, spacers are often not necessary, but canthal reconstruction often is. Make no mistake, these cases are quite tricky. They involve working with scar tissue and some irretrievable loss of normal structures, and the results are often not perfect. So patients must be prepared that their reconstructions, even in the very best of hands, while almost always better, are often not perfect.
Mid Face Lift in Conjunction with Spacer Graft
It is very difficult to answer your question without seeing you in person and examining you but spacer grafts and midface lifts are often done in conjunction when there is a severe lower eyelid retraction
Mid facelifts are as diverse as the surgeons who do them. The eyes are a unique entity and should be done after the mid facelift to know how much skin is appropriate to address.
Mid-facelift does not address lower eyelid deficiency
A midfacelift is not done in conjuncture with a spacer graft. It is important to have a spacer graft done first so as to address any lower eyelid issues prior to embarking on a midfacelift procedure. A cheek implant would also be an additional consideration other than a midfacelift.
Usually yes, but not always. Midface lift recruits anterior lamella (skin layer of the eyelid). Spacer graft addresses middle and posterior lamella shortening of the eyelid, which is often present with postblepharoplasty eyelid retractions.
Face Lift, Mini Face Lift, The Palmer Celebrity Face Lift, Beverly Hills Face Lift
No, mid Face Lifts address the mid section of the face. Placing grafts along the lower eyelid bony ridge is a separate issue.
Part of the problem with lower lid is midface descent with age. Elevating the midface would give extra support to the lower lid and would reduce the risk of recurrence lower lid ectropion.
What is the issue in the lower lid?
You did not state why there was a deficiency of the lower lid.
Unless you have had prior surgery or an unusual anatomy of the lower lid, spacer graft would not be needed.