Is There a Way to Lift the Cheeks Vertically Rather Than Horizontally?

Question

I've noticed that in most people 25 and younger, they have less space between the apple of their cheeks and their under-eye area, creating a "lifted" look. Is there a way surgeons can shrink a stretched cheek-to-eye space vertically, neither using fillers to "balloon" the area nor traditional diagonal face-lifts that can create a stretched cat-face look? Or would any type of incision anchor down the under-eye area?

Larry S. Nichter, MD, MS, FACS · Answer

Cheek Lift Can be Performed through Lower Lid
	The answer is YES. Using a lower lid, blepharoplasty approach, the cheek fat ("SOOF") can be advanced and attached to the fibrous tissue on the lower orbit bone (called periosteum). This tends to improve the cheek fullness and the hollowing that occurs in many lower lids. This procedure is called a cheek lift or midface lift.

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

James M. Pearson, MD, FACS · Answer

Thank you for your question. The mid-face region roughly correlates with the area between the lower eyelid and the corner of the mouth. You are correct to suggest that a more vertical vector of lifting is preferred in the mid-facial region as compared with the lower facial region. A mid-face lift, sometimes referred to as a cheek lift, can help to restore fullness to the mid-face by vertically repositioning the soft tissue of the cheek to a higher, more youthful position on the cheek bone. At the same time, lower eyelid appearance is often improved as the repositioned cheek tissue is more favorably redraped over the lower orbital rim, minimizing the unfavorable hollow appearance of the lower eye region. A well performed mid-face lift can be a powerful method for facial rejuvenation. Learn more about this procedure on our site. Warm regards.

Nima Shemirani, MD · Answer

Hi,

	You are exactly right in what happens as we get older.  In a youthful face, you can't tell where the eyelid ends and the cheek begins.  Personally, I think adding volume to the under eye area and upper cheeks will help get you where you want to be.

	This can be done with Restylane, Juvederm, and even fat transfer.

	Best,

	Nima Shemirani

Umang Mehta, MD · Answer

Great question. What you are describing is a midface lift. In this procedure, small incisions are made on each side inside the upper lip, above the gumline which sits just below the cheek. A second tiny incision is made behind the hairline in each temple. The soft tissue of the cheek is freed up from the underlying cheek bone and it is suspended with the use of a dissolvable device called an Endotine. The vector of the lift is predominantly vertical in direction.

	This midface lift can yield excellent, natural looking results as a stand-alone procedure or can be done in conjunction with facelift, eyelid surgery, or fat transfer. Midface descent is an often undertreated and unrecognized issue. I occasionally see patients who come to me after having had a prior lower facelift or necklift from another surgeon and they exhibit a Nike "Swoosh" look on the cheeks, with the jawline being tight but the midface sagging. 

	Seek a consultation with a facial plastic surgeon or plastic surgeon to determine if you would be a good candidate for this procedure. 

	Best Regards,

	Dr. Mehta

Toby Mayer, MD · Answer

Vertical cheek lift is the best way to lift the cheek in my opinion and I use the Endotine device to fix it to the bone. This way the vector is upward and lifts the sagging tissue in the opposite direction as gravity! Good thinking.

Moneer Jaibaji, MD · Answer

Thank you for the question, what you are describing is mid face lift. With this procedure the cheek is lifted upward through a lower lid incision. If combined with fat advancement to the lower lid, the results will be better. You need to have a consultation with a plastic surgeon to address this questioning detail with you. Mid face lift is one part of upper face rejuvenation surgery.

Philip Young, MD · Answer

IMO midface lifts are not a good procedure. They don't really do what you want them to do. There are new thoughts out there on how to rejuvenate people's faces in a younger and natural way. There are incision less face lift alternatives out there.

William Portuese, MD · Answer

The best way to lift the cheeks is with volume augmentation. The cheeks sag because of volume reduction due to the aging process. Increasing volume in cheeks with cheek implants restore youthfulness, volume and lift at the same time. A simple vertical or horizontal lift will not look natural.

James Rosing, MD, FACS · Answer

You are inquiring about the mid-face. This area of the face is tricky and can be dealt with in a number of ways from a lower blepharoplasty incision, intraoral incision with malar augmentation and with a facelift incision. If the patient is undergoing a combined blepharoplasty and facelift procedure, I will deal with the midface through both the lower blepharoplasty incision and the facelift incision. Through the lower blepharoplasty incision, I will often take down the orbitomalar ligament and perform a cheek lift, anchoring the cheek flap to the temporalis facia. Through the facelift or preauricular incision, I will dissect far enough anterior to allow for my SMAS elevation to continue from the more lateral part of the cheek to the more medial or 'apple' portion of the cheek, which creates an elevated midface. The combination of these two approaches results in a satisfying restoration of the midface profile. The lift vector is vertical. The skin is then redraped in an oblique vector that appears the most natural and avoids the 'cat-face' look.

Is There a Way to Lift the Cheeks Vertically Rather Than Horizontally?

Answers (12)

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