Can a Mid Face Lift Also Improve Mild Skin Laxity Under Eyes?

I am considering a mid facelift and have a small amount of loose skin under my eyes. Would the mid facelift address this or would I have to have additional surgery for the under eye skin?

Doctor Answers 24

Midface lift for under eye skin laxity

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I think a minimally invasive cheeklift would be just the ticket for your lower eyes.

There are many types of cheeklifts. They all do different things. I have found the cheeklift that works best for lower eyelid eyelid skin excess is the minimally invasive cheeklift with an incision at the corner of the lower eyelid. In our practice we term this the USIC cheeklift (R). This elevates the cheek and tightens the lower eyelid skin. It does not touch the orbital septum, the layer that so often causes problems with lower eyelids. Instead, it addresses the problem at an entirely different level (more superficial, to so called "sub-orbicularis" level).

Conventional lower eyelid surgery can pull down on the lower eyelids if skin is "tightened". Therefore the best way to There are several different types of midface lifts, many of which are referenced in articles and book chapters we have written below.

Likewise I do not favor the use of a canthopexy plus conventional lower eyelid surgery. I believe this can give an excessive high transition to the side of the eye, a catlike appearance.

I do not believe cheeklifts performed through the mouth and temple, or with endo tines improve lower eyelid appearance. As some doctors have noted, it can actually worsen it.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 188 reviews

Mid Facelift can wrinkle your eyes

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Hi Pam,

Your lids don't look bad at all but the photo you published is not an easy one to evaluate. In general your lids don't look too bad. You appear to have good bony support and most importantly, your midface does not look descended. Again, don't take my word for it on any of these details since I'm not seeing you in person.

A properly done midfacelift will bunch up more skin under your eyelids (unless the midface gets pulled in a lateral direction -- which is not the direction that it came down from!). If your main concern is your lower lids then this surgery is not what will make you happy. Your best bet is to be examined by a board certified plastic surgeon and see what his opinion is on your particular situation. His opinion should clarify many of your concerns that can't truly be answered until a physical exam has been done. There are many technique variations that can be used to resolve your particular case, so keep searching!

Best Wishes,


Midfacelift Can Worsen Undereye Skin

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Once the midfacelift pulls up the cheek and nasolabial groove it can cause some more bunching of the skin under the eyelid.

To avoid that problem you can get lower eyelid surgery (blepharoplasty) or laser resurfacing or a peel to tighten the loose skin of the eyelid.


Mid facelift improves lower eyelids.

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1) Here's a different opinion. The way we do it, a mid facelift can: a) lift the corners of your mouth, b) create fullness in the upper cheek (the "oggee" shape), and c) smooth out the transition between your cheeks and the outer part of the lower lids. I don't think you will need an additional lower blepharoplasty.

2) It's all a matter of how the mid facelift is done. We do it though the mouth.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Cheek lift and lower eyelid surgery

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This is a great question, but one that is a bit hard to answer without knowing what type of cheek lift you are talking about. Cheek, or mid-face lifts can be done in many ways through many approaches, and will be called many different things.

Here in Santa Barbara, my approach to the mid-face and cheek is through an incision just lateral to the lower eyelid margin. Through this incision, the cheek tissue is freed and elevated. With the raising of this soft tissue of the cheek, the lax eyelid skin will bunch up under the eye, and require simple excision in the most superficial plane. This allows for tightening of the eyelid skin, as well as rejuvenation of the midf-ace/cheek region in one relatively minimally invasive procedure with little risk for eyelid problems. Patients also find an improvement of the shadows in the nasolabial folds, and a general rejuvenation of the "brightness" of their face.

I find that this is a great operation in a younger woman with only the beginnings of apparent facial aging. In the older patient, I often combine this with a face lift procedure in what we call a composite face lift. This approach has applications for many different stages of facial aging, and has provided an excellent rejuvenation for many women here in Santa Barbara.

Midface Lift

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Thank you for your question!

Mid facelifts can be performed in many different ways. Usually when a mid facelift is performed, it will actually create more bunching of the skin under the eyes. Additional surgery, such as lower blepharoplasty would usually be necessary if you chose to do a mid facelift. There are also several laser treatments and peels that could help with the excess skin as well.

Going by the picture you submitted, it does not appear that a mid face or any lower eyelid surgery is necessary at this point. I would try the less invasive procedures first, and if this doesn't help, then find a board certified plastic surgeon who specializes in this area to lay out your options for you!

Best regards,

Dr. Speron

Sam Speron, MD
Chicago Plastic Surgeon

You may need a lower eyelid blepharoplasty with your mid-facelift.

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When your droopy cheek fat (malar fat pad) is lifted, this will result in excess skin in your lower eyelid area. This can easily be remidied with a lower eyelid skin-pinch blepharoplasty. This does not take alot of extra time, and will result in a pleasing lower eyelid appearance.

I hope this is helpful for you.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 429 reviews

Midface lift and lower eyelid skin

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The question you have posed is a good one. In certain cases depending upon how the technique for midfacelift is done, you might get some improvement in lower skin laxity; however, this may cause some additional wrinkling. It depends really on the vector or direction of the lift. Sometimes we do an extended blepharoplasty that can help both the midface and the lower lid laxity. Sometimes lifting the midface and redraping the skin toward the temple will improve the laxity and sometimes it can make it slightly worse and the skin can bunch up under your eyes.

If you are in Toronto or near there, I would see Dr. David Ellis or Dr. Peter Adamson as they will give you an honest opinion. I hope this information helps.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Midface lifts and lower lids

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The mid-face lift is a wonderful procedure which will help to elevate your cheeks into a more youthful position. It can also be used to decrease the hollowness below your lower eyelids by elevating the cheeks in a superior direction. Unfortunately, this will cause some bunching of the lower lid skin and a very conservative blepharoplasty would likely need to be performed in order remove some of that excess skin. Your surgeon will be very careful in the amount of skin that is removed to prevent any lower lid malposition that can result if too much skin is removed.

Prevent excess eyelid skin and lift the midface at the same time

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I told the makers of the forehead Endotine device to make me one for the cheek. They did make one for the cheek and we televised this to Europe about 5-6 years ago. It worked very well. This is put in thru the eyelid incision and fixed to the bone. In this way the excess skin can be removed without making wrinkling of the lower lid skin worse. Besides lifting the cheek, tissue can be placed in the aging groove under the eye restoring a more youthful look.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.