Where is a Mini or Midface Lift Anchored? Is the Tissue Sutured Under the Eyes or Near the Ears? A Surgeon Once Warned Me Away

from this procedure because she said it pulled on the lower eye lids.

Doctor Answers 14

Mini or mid face lift mystique

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I believe some background information is necessary so that you can better comprehend this answer. In general, a facelift (aka rhytidectomy) is a surgical procedure to treat sagging skin and soft tissue of the face and neck. Classically, this is performed through access incisions that are strategically placed to hide the resultant scars, so that underlying soft tissue can be elevated in a more youthful location, sustained with support sutures, and excess skin is then removed when necessary. Over the last 40 years, there have been at least as many variations of this procedure designed, in part, to treat the wide variations of aging and facial characteristics that makes us all unique. Variations of these operations have also been developed to attempt to improve longevity of the results, minimize scarring, and some to decrease downtime. 

A mini facelift (aka weekend lift, lunchtime facelift, rejuvenation lift, s-lift) is basically a face lift where incisions are placed around the ears and the skin undermining is usually minimized and the lift is often created by pulling on the skin and supporting the lift at the suture line. This is usually reserved for patients with only early signs of aging. It can sometimes be performed under local anesthetic and there is usually less downtime. When used on someone with more advanced signs of aging it will usually not produce a very long term result;months to a year. There are many variations of this facelift variation. 

A mid facelift also has many variations. Usually this implies that the central portion of the face is being tended to. This is used to correct the lower eyelid cheek interface. This operation can be performed through an extended lower eyelid incision or a variation of the preauricular (in front of ear) incisions or a combination of both. It is imperative that the underlying support soft tissue is anchored well or it can lead to unsightly cosmetic and functional lower eyelid problems.

Before entertaining any of these procedures, I highly recommend that you consult with a board certified plastic surgeon that has experience with these procedures.   

Best Suturing for Midface Lift also called Suspension Cheek Lift

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A midface lift is sometimes called a suspension cheek lift. This is because it is anchored above the cheeks, lateral to the eyes, in the temporal region. Specifically, it is most commonly anchored to the temporalis fascia.

Because this is some distance away from the eyes, if this procedure is done well, it rarely causes any pull on the lower eyelids. It may improve the position of the outer eyebrows by elevating them along with the cheeks - often this is a very nice added benefit rather than something you should be warned away from. The direction of pull on the cheeks is upward and outward and on the eyebrows is upward.

Michael R. Macdonald, MD
Bay Area Facial Plastic Surgeon
4.6 out of 5 stars 18 reviews

Where is a Mini or Midface Lift Anchored

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A “mini” or “mid-face” lift is a very nice procedure for the perfect candidate, and not all patients are good candidates for this.  When I perform “mini-rhytidectomy”, the procedure in no way pulls the lower eyelids down, so I’m unsure what your surgeon was referring to. 

Jonathan Ross Berman, M.D. , F.A.C.S.

Jonathan Berman, MD
Boca Raton Plastic Surgeon
4.7 out of 5 stars 19 reviews

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Midface Lift vs MiniFace Lift

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Midface lift implies lifting the midface or cheeks and this is probably what was meant that was anchored under the eyelids.  A minifacelift can mean anything but in general produces mini results.

Mini and Mid Facelifts

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The terminology about facelifts is somewhat confusing. A facelift, including a mini-facelift, really concerns the lower face and neck. Some mini lifts really do very little to lift these areas. Others, like the MACS lift or Today's Facelift use many of the techniques of a mini facelift, but provide full correction and long lasting results. A mid facelift is a designation of a procedure done in the mid face to lift the central cheek and lower eye area. The first methods did cause pull on the eyes. However, the more modern procedures lift the mid cheek and lower eyelids safely with anchors lateral to or above the eyes. See a Plastic Surgeon with significant experience with these procedures to reduce any risks.


Robert T. Buchanan, MD
Highlands Plastic Surgeon

Where is a Mini or Midface Lift Anchored? Is the Tissue Sutured Under the Eyes or Near the Ears? A Surgeon Once Warned Me Away

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 I have performed Facelifts for 25 years and they should not employ suspension "anchor" sutures IMHO as these do not hold up.  Face Lifts, including our minimal incision Face Lift "Celebrity Facelift" should have the following characteristics to be effective:

  1. There must be an incision that contours around the front of th ear allowing the removal of excess skin.
  2. The underlying SMAS layer must be dissected, lifted, trimmed and re-sutured instead of merely folding or suspending it with anchor or suspension sutures.
  3. Excess fatty tissues must be removed and the cheeks aesthetically shaped to create a natural more youthful and attractive face.

 Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Midface Lift

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There are a number of techniques that are tailored to the needs of the specific patient.

Anchor Point for Midface Lift

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The anchor point for a midface lift will depend on the technique used by your surgeon. Lower eyelid distortion is a possible complication so select a surgeon experienced in this operation.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 42 reviews

Where is a Mini or Midface Lift Anchored?

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For any lift procedure, anchor points are key to improve the results and avoid distortion of facial structures. The anchor points has to be tough facial tissue. Frequently multiple anchor points are used for better disrtribution of skin tension. If lower eyelid approach is used and a blepharoplasty is planned then canthopexy is key to prevent pulling of lower eyelids. Additional anchor points are lateral orbital rim, temporal area and fascia in front of the ear.

Sanjay Parashar, MD
Dubai Plastic Surgeon
4.6 out of 5 stars 23 reviews

Midface Lift Tissue Suspension/Fixation

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Your question is most likely directed towards the midface or cheek lift procedure. This is a very technique sensitive operation that is done primarily through a lower eyelid incision and the key is fixation of the lifted tissues. Lower eyelid distortion is its most common problem and there are many ways and tissue points which surgeons achieve anchorage of the lifted tissues. My preferred location is a cranial suspension point, away from and well above the eye area. While it is a good operation for cheek or malar tissue sagging, patient selection is the key. It is an operation that has been over-utilized in the past and complications rates have been significant, but if well done with good fixation in the right patient it is a very effective midface rejuvenation operation. 

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.