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An Endoscopic Midfacelift with endotine fixation is an attractive alternative to the traditional facelift procedure to rejuvenate sagging cheeks. The Endoscopic Midfacelift elevates and replaces the soft tissues of the cheek and midface to the the position they occupied in youth. No skin is resected in this procedure, so it avoids the "wind tunnel look" that can be produced by the excessive tightness of the facial skin that can result from an aggressive facelift. Just as importantly, the emphasis of our Endoscopic Midfacelift, is on restoring the 3-dimensional volume of the face, resulting in a softer and more naural facial contour. The endoscopic approach allows the access incisions to be hidden behind the hairline and inside the mouth. Finally the endotine, which is used to hold the repositioned soft tissues in place, is completely resorbed by the body within 6-9 months after the procedure, by which time a lattice of soft tissue has formed at the site of fixation that locks the surgical correction in place. Our patient satisfaction with this procedure has been very high, and because of the naturalness of the result and the well-hidden nature of the scars, i believe it represents the best alternative to a conventional facelift for rejuvenating the cheeks and midface area.
Many different options exist to improve the midface, ranging from minimally invasive to facelift surgery. As a board certified plastic surgeon, I get asked this question daily. As a general rule of thumb, the facelift is most effective. The less invasive, the less effective. Most important is to meet with each patient to determine what type of results are desired. Both males and females suffer from aging, yet I find that every patient has different needs. One person might be satisfied with a subtle improvement, while another wants a more dramatic result. In the less-invasive arena, there is microneedling with RF (radiofrequency), which can be performed with topical numbing cream. It involves treating the skin with radiofrequency to stimulate collagen formation, thereby tightening the skin. This can be combined, if need be, with dermal fillers (which are temporary) to help revolumize the sagging area. A slightly more invasive procedure would be using thread lifts to help resuspend the skin in a higher position. This is performed with a suture material that dissolves over time and has minimal downtime, and threadlifting is performed in a treatment room (not operating room since it is not a surgery). Fat transplantation can sometimes accomplish such revolumizing, and a benefit to this approach is that the fat is permanent (unlike the fillers). The gold standard is the facelift, which is the best treatment for moderate to severe sagging of the cheeks. A properly performed facelift should leave a patient looking refreshed, but not at all pulled. A natural result is key!
It’s important to realize thatfacelift procedures are the gold standard for treating facial aging. Theseprocedures are versatile, reliable and very predictable. They can be used totreat a wide range of anatomic deformities that are frequently associated withfacial aging.No other therapeuticmodality has the range and effectiveness of the facelift. It’snot unusual for patients to seek less aggressive treatment options. This mayoccur for a variety of reasons including misinformation, expense, fear ofsurgery and co-existing medical problems to name a few. Whenthis situation arises a large variety of options exist for treating facialaging. These include cheek implants, endoscopic mid face lifts, injectablefillers, fat transfers, lasers and chemical peels.Withoutpictures or a physical examination it’s virtually impossible to make a specificrecommendation regarding what options will benefit any particular patient.This decision will depend upon the patient’sanatomic findings and aesthetic goals.Underthese circumstances consultation with a board certified plastic surgeon isappropriate.This surgeon should be ableto perform an evaluation and formulate an appropriate treatment plan.
Fillers can help depending on your concern. If you have deep creases around your mouth and nose as a result of your sagging cheeks, or have jowls, fillers can help. I have found that fat transfer can also help and the results tend to be permanent.
In my experience, best natural option for improving sagging cheeks isfat grafting with PRP. Fat grafting allows a natural restoration of fat andvolume that has been depleted over time. This procedure is minimally invasiveand addition of PRP to fat allows a long lasting results.
Fillers can add volume to your cheeks to create a lift and eliminate sagging. Fat transfer can also be performed as a less invasive method of facial rejuvenation.
