Mid Face Lift or Cheek Lift for Laxity Under Eye?

To correct skin and muscle laxity under the eyes, which procedure has the least chance of changing eye shape? The mid face lift or cheek lift with skin removal? Thanks.

Doctor Answers 7

Laxity under the eye

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You have at least 5 ways options. Which is best depends on you and your surgeon.

  1. Lower lid lift - removes excess skin. Trims skin, slightly snugs muscle A canthal suspension adds further support. Risk of eye shape change - low
  2. Mid face lift using an eye lid incision. Lifts upper face tissue, attaches to bone beside eye. Changes eye shape temporarily Higher risk of scarring and eye deformity. 
  3. Cheek lift through hair line incision. Lifts and lifts cheek tissue but avoids eye.  Eye lid skin may be needed. Risk of eye shape change - low 
  4. Skin peel - tighten skin only. Risk of eye shape change - low
  5. Canthopexy - lifts eye itself by cutting attachment to bone. Will change eye shape.

Eye anatomy is complex. Consult an experience Board Certified Plastic, Ophthalmic or ENT surgeon with lost of cosmetic experience to discuss this. Best wishes. 

Changing the shape of the eye with face lift, mid-face lift, cheek lift, or eyelid procedure

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In many ways these terms are used interchangeably. So it is difficult for me to recommend one over the other.

The primary procedure which alters eye shape is called a lateral canthoplasty.

This is a procedure where the outer corner of the eye is elevated to a new postion generally to achieve greater support to the lower eyelid. This is commonly performed in individuals who have a lax lower eyelid when either a lower lid blepharoplasty or cheek lift. The problem is that if you put any weight on the lower eyelid it will pull it down and cause it to turn outwards.

This is similar to putting a heavy blanket on a clothesline. It will make the line sag. The only way to avoid this is tighten up the line. This is an oversimplified explanation of a canthoplasty.

The canthoplasty is the procedure that tends to permanently alter the shape or orientation of the eye.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Procedures for laxity under the eye

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Either procedure has the potential to change the shape of your eye. However, this is not a very common event. To determine which procedure is best for you, you need to have a consultation with a surgeon who can work with you to make that decision based on your specific face characteristics and anatomy.

Deason Dunagan, MD
Huntsville Plastic Surgeon

Changing the shape of the lids in lower lid surgery

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The problem with laxity in the lower lid is that it is usually necessary to tighten the lid into the bone rim (canthopexy or canthoplasty) to limit the risk of the eye pulling down in the result.  This tightening can narrow the width of the eye and make you look Asian.  These patients frequently say, "I wanted to look better, not different." 

Cheek implants may be a better option

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A better option for not changing the shape of the eyes would be simply to place cheek implants to restore volume to the cheeks rather than trying to do a cheek lift. Cheek lifts and mid facelifts can change the shape of the eyes, making them smaller. This will not happen with a small cheek implant.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Midface and cheek lift are the same procedures.

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What you describe can usually be corrected with and lower lid blepharoplasty. A cheeklift is done when the cheek is sagging and we want to raise it. The safest procedure for not changing the lower lid position is a blepharoplasty done by a skilled surgeon.


Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Both have the potential to alter the shape of the eyelid.

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Dear Skintech

Both of these procedures have the potential for altering the lower eyelid shape. The skin and lower eyelid muscle laxity are the results of the lower eyelid sagging.

Tightening these structures by tighting the lower eyelid with a canthoplasty may actually make the lower eyelid position worse.

A chemical peel of this area with Phenol 89% is sometimes very helpful to shrink eyelid skin without creating deep scar in the lower eyelid.

In Chicago, Allen Putterman has done some very nice work at firming this area with minimal alteration in the eyelid position. You might consider investing in a consultation with him to learn what he recommends for you.

Dr. Steinsapir

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 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.