Mid Face Lift or Cheek Lift for Laxity Under Eye?

Question

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.

Kenneth D. Steinsapir, MD · Answer

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

William Portuese, MD · Answer

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.

Toby Mayer, MD · Answer

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.

Otto Joseph Placik, MD · Answer

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.

Deason Dunagan, MD (in memoriam) · Answer

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.

Richard P. Rand, MD, FACS (retired) · Answer

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."

Mid Face Lift or Cheek Lift for Laxity Under Eye?

Answers (6)

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