What is the Best Mid Facelift Procedure?

I had a facelift about 10 years ago. Recently, I have noticed that when I smile the area from the corner of my mouth to eyes is a mass of wrinkles. I use fillers around my mouth and have no deep lines around the nose or mouth when I am not smiling. I've read some real horror stories about this procedure particularly droppy, misshappen eyes. My greatest assets are my smile and yes. I would hate to ruin them. Is there a procedure that does not effect the lower eyes?

Doctor Answers 8

Facelift vs midfacelift

A mid-facelift  will not address excess wrinkles in the lateral cheek.  A properly performed facelift will address these smile wrinkles and not change the shape of your eyes.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

What is the best mid facelift procedure?

10 years after a facelift, patients may sometimes desire a touch up, and a mid facelift can be a great option. Photos and an exam would really be necessary to give you the best advice. Have you considered the option of adding volume to the face? There are some great collagen stimulating fillers such as Sculptra and Radiesse that yield fantastic results. Radiesse will have a more immediate effect. Sculptra can take several injections, and several months, to see a difference; however, Sculptra has the longest effect (2 years or more) of any filler.

A procedure called a vampire facelift is also a great option. WIth a vampire facelift, PRP is mixed with a filler like Restylane and injected under the lower eyes and into the cheeks to give a non-surgical lift to the face. Platelet-rich plasma or PRP is extracted from the patient’s own blood using a centrifuge.  PRP is a natural rejuvenator that aids in the healing process and stimulates collagen growth.

Vampire needling is possible as well, where we use a series of tiny needles in a Dermapen to inject PRP into the top level of the dermis, allowing it to slowly sink into the face. The result of vampire needling is an overall glow to the face, giving a fresh and youthful look while reducing fine lines and wrinkles.    It has very little down time and is perfect for minor wrinkle improvements.

Overall, there are many possibilities for you to improve the appearance of your face. A consult with a board certified facial plastic surgeon would be a great next step! Thank you and I hope this helps. Please feel free to ask any additional questions, I would be happy to answer them for you!

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 47 reviews

Improve cheek fullness

I would recommend you see a Board-Certified plastic surgeon for his/her opinion. Since you have already had a facelift and the associated scars, you may want to explore revision within those scars to improve fullness in the midface. You also might want to explore volumizing options such as fat grafting or Sculptra injections. These procedures should not pull on the lower lid.

Michele A. Shermak, MD
Baltimore Plastic Surgeon
4.8 out of 5 stars 50 reviews

Pre-Auricular Face Lift

The dynamics of your problem are typical. You need a pre-auricular facelift with redraping of the skin in the temple area. This will have little effect on your lower eyelids. Whether you need work on the lower eyelids can then be addressed as needed.

Richard Galitz, MD, FACS
Miami Facial Plastic Surgeon
4.6 out of 5 stars 11 reviews

Mid facelift is a great procedures

Mid-facelift is an excellent procedure if done properly for the appropriate individual with the right surgeon. I would recommend going to see a few plastic surgeons for consultations to see what the best procedure is for you.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.3 out of 5 stars 9 reviews

Midface options after Facelift

It is most important to determine what is the reason for your midface issues.  That said options include:

1.  Filling or adding volume to the cheek and cheek bone areas.  Fat looks great and can be long lasting. Different fillers are options as well.  Again, not necessarily in the wrinkles themselves but globally in the area.  Sometimes after a facelift one can get a slight sinking in of the tissue just in front of the ears.  This is another area to treat and may be part of your problem.

2.  Midface lift.  I do perform a midface lift.  I use the endotyne resorbable implants.  There were some issues with the outer part of the eyes with past aggressive surgery but I have not found that to be a problem.  Ask for before and after photos.

3.  Resurfacing the skin if fine wrinkles are more the problem.

4.  Some combination of the above.


In summery, you need a thorough evaluation before I can direct you specifically.  There is a reason to get a comprehensive consult.  Find someone who can offer you many different options.  Good luck!


Hannah Vargas, MD
Kansas City Facial Plastic Surgeon
4.7 out of 5 stars 45 reviews

What are the best Face Lift and Mid face procedures?

 I have performed Face Lifts for over 20 years and the best technique is the one that accomplishes your goals with the smallest incisions, healing, recovery time while making you more attrcative in a predictable manner.  I personally have never liked the way the subperiosteal mid face lift distorts the corners of the eyebrows, eyes and mouth.  This occurs because of the direction of tissue pull and IMHO, makes this type of Face Lift a no go. 

 I'd have to see pictures, of your face, to determine if you have Jowls, or some patrticular issue making one Face Lift technique more applicable than another.  With a previous Face Lift, I typically perform a minimal incision Face Lift for touchups. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Best midface procedure.

Best midface procedure is the one that is appropriate for you and I would have to see your photos to see if you are even a good candidate for this.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 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.