Anti-aging
Anti-aging
The area that extends from the corners of the mouth to the eyes is commonly known as the midface. As people age, one of the primary indications is a reduction in cheek volume and sagging cheeks. This is evident by the elongation of the distance between the lower eyelid and cheek, the appearance of tear and malar troughs, and a decrease in the youthful contour of the cheeks. Other signs of aging, such as jowls and nasolabial folds, may also emerge.
The midface region refers to the area beneath the eyes, around the cheekbones, and up to the upper lip. As people age, the skin and fat in this region begin to sag, leading to a tired or worn-out appearance. The mid-facelift, also called a cheek lift, is a minimally invasive surgical procedure that utilizes the patient's own tissues to restore the natural curvature of the eyelid-cheek region and remove excess skin or wrinkles.
During the mid-facelift procedure, the aim is to elevate and enhance the position of the patient's cheekbones while also improving the continuity between the eyelid and cheek. The goal is to reposition the skin and fat of the cheeks, leaving no visible scars. The procedure can also help soften the nasolabial fold, which connects the nostril to the cheek, resulting in a more youthful and refreshed appearance.
A mid-facelift may be performed alone or in conjunction with other cosmetic surgery procedures such as eyelid surgery, browlift, neck lift, or laser skin resurfacing. This may be done to achieve a more comprehensive aesthetic result.
A mid-facelift is best suited for younger or middle-aged individuals with under-eye hollows or sagging cheeks. However, those with loose skin in the neck area or more pronounced signs of aging may require a more invasive facelift procedure.
To ensure safe and successful facial surgery, it is crucial to understand the fascial planes of the face. These planes consist of various layers, starting from superficial to deep, such as the skin, subcutaneous fat, superficial muscular aponeurotic system (SMAS), parotid masseteric fascia, and parotid gland. The SMAS transitions into the mimetic muscles of the face beyond the parotid gland's anterior boundary, including the zygomaticus, buccinator, risorius, and others. The SMAS further transforms into the temporoparietal fascia (TPF) above the zygomatic arch and the platysma inferiorly, covering the body of the mandible.
As the facial nerve runs deep to the SMAS layer and its adjoining fasciae, dissection on the superficial surface of this layer is recommended to avoid complications. The frontal branch of the facial nerve can be approximated by a line that extends diagonally from 0.5 cm below the tragus to 1.5 cm above the lateral brow, while the primary buccal branch controlling the zygomatic muscles is located at Zuker's point, halfway between the root of the helix and the oral commissure.
In mid-face lift surgery, the primary objectives are to reduce the nasolabial folds (NLFs) and restore youthful malar volume. The NLFs are caused by the mimetic muscles' close proximity to the dermis without intervening fat, similar to the attachment of the upper eyelid levator aponeurosis to the dermis. Restoring volume to the malar fat pads and repositioning them may be more effective than directly filling the NLFs with hyaluronic acid or calcium hydroxyapatite.
The medial and lateral sub-orbicularis oculi fat pads, located above the malar fat pads, contribute to the tear trough deformity seen in aging faces when separated from a descending malar fat pad. To restore fat compartments to their youthful positions, the identification and division of subdermal retaining ligaments, such as the zygomatic and mandibular retaining ligaments, may be required. The mandibular retaining ligaments form the pre-jowl sulcus overlying the medial mandibular body as the buccal fat pad descends with age.
The tissues situated above the cheekbones and below the eyelids typically droop and lose volume due to the aging process and the impact of gravity. This results in the flattening of cheekbones, the appearance of hollow lower eyelids, and deeper nasolabial folds. Most significantly, midface descent creates a separation between the lower lid and cheek, leading to a tired, older-looking appearance.
To address these changes, the midface lift has become a popular surgical procedure for patients seeking to treat aging signs. Unlike traditional facelift surgery that primarily targets the lower half of the face, the midface lift is specifically designed to elevate the malar fat pad, restoring fullness to the eye and cheek areas, thereby creating a more youthful and rejuvenated appearance.
Moreover, the midface lift may be used to address severe lower eyelid retraction that has not improved after previous blepharoplasty surgery, facial nerve palsy, or facial trauma. In such cases, a midface lift can help to improve facial symmetry.
However, it is important to note that a midface lift does not address crow's feet, fine lines, and wrinkles in the midface region, nor does it treat all lower eyelid issues. If these are primary concerns, alternative procedures like BoNT injections or laser resurfacing may be more appropriate.
During your initial consultation, the surgeon will assess your suitability for midface lift surgery based on your medical history and reasons for pursuing the procedure. They may also ask about any current medications you are taking, allergies you may have, smoking habits, and previous surgeries.
If you are deemed a suitable candidate for a midface lift, the surgeon will provide you with instructions on how to prepare for the procedure. For instance, if you are taking aspirin or other nonsteroidal anti-inflammatory drugs like Ibuprofen or Voltarol, you may be required to stop using them temporarily before the surgery, as they can increase the risk of bleeding.
You may also be asked to quit smoking for a specified period leading up to the procedure to minimize the risk of complications and ensure optimal healing.
The midface lift procedure can be performed using various techniques and incisions, all of which involve mobilizing the midface tissues and malar fat pad while releasing multiple retaining ligaments. Once the cheek tissues have been released, they are elevated and resuspended to a higher position on the facial bone and eye socket, with sutures used to close the incision.
The duration of the surgery typically ranges between 1-2 hours, depending on the patient and the extent of the procedure. Most patients undergo general anesthesia, which ensures they remain comfortable throughout the procedure.
The midface lift can be performed alone or in combination with other rejuvenation procedures such as a brow lift or blepharoplasty. It can also be performed as a "blepharoplasty plus" procedure, which combines eyelid and cheek contouring through the same incision around the eyelid.
The midface lift is highly effective in restoring youthful volume to the cheeks and improving the lower eyelid's harmony with the rest of the face. It can also be a useful tool in enhancing the outcomes of a lower eyelid blepharoplasty.
Recovering from a midface lift typically takes 7-10 days, which is quicker than the recovery time for a standard facelift. After the procedure, patients are advised to rest for a week before returning to their normal activities.
It is common to experience bruising, swelling, and inflammation following the midface lift, but these symptoms usually subside after a few days. Applying ice packs to the affected areas for the first 48 hours can help reduce swelling. Patients will also be prescribed appropriate pain relief, but aspirin and Ibuprofen should be avoided as they can increase the risk of bleeding or bruising.
While midface lifts offer immediate benefits, the cheeks and eyelids are initially "overcorrected," causing them to appear overly elevated for the first 2-3 weeks. However, this eventually settles into a more natural position.
The midface lift is typically performed as a day case, and patients do not need to stay in the hospital overnight. However, since the procedure is performed under general anesthesia, it is essential to arrange for someone to pick you up from the hospital as driving oneself home is unsafe.
Patients can resume exercise and other activities that raise their heart rate after two weeks. However, they should avoid using makeup or styling products in the healing areas for the first week, as this can hinder the healing process. It is best to wash and dry the areas with gentle patting instead of rubbing.
A mid-facelift can deliver remarkable results, making you look years younger by eliminating sagging and producing more defined, lifted cheekbones. Following the surgery, your cheeks may initially appear overly defined, but they will eventually settle into a more natural position over time.
It is important to note that the mid-facelift procedure is not designed to improve the lower face or neck. However, there are alternative options available if you are looking to improve those areas.
After a midface lift, patients can expect some swelling and minor bruising of the cheeks, although this is relatively uncommon. Infection is also rare, but patients will receive a short course of antibiotics following the treatment as a precaution. Numbness in the cheeks is typical and will usually disappear within 4 to 6 weeks, while mild cheek tenderness is to be expected. The implant may be felt until it reabsorbs after 10 to 12 weeks.
Facial nerve weakness is uncommon and typically resolves within 4 to 6 weeks. Scarring in the scalp is typically minimal, and in rare cases, scar thickening may make it more noticeable. To aid in healing and reduce bruising and swelling, patients are advised to take Arnica tablets before and for two weeks after the midface lift.
The cost of a mid-facelift procedure can vary depending on several factors, including the location, the board-certified facial plastic surgeon, and the length and complexity of the surgery. On average, a mid-facelift can cost anywhere between $4,000 and $10,000.
1. How long does midface lift results last?
Compared to other anti-aging cosmetic treatments like injectable fillers, a midface lift produces long-lasting and permanent effects. Patients usually do not require additional midface lifting treatments. Most patients are delighted with the outcomes of their midface lift treatment since it enhances their appearance, particularly when combined with blepharoplasty. When performed correctly, the outcomes appear natural. We advise maintaining a healthy lifestyle and undergoing other non-surgical treatments as you age, if necessary, to maintain a youthful appearance.
2. Is midface lift different to a facelift?
No, these are two separate procedures. A midface lift targets the center of the face, from the eyelids to the cheekbones and up to the upper lip. On the other hand, a facelift addresses the lower portion of the face (neck, mouth, and jowls). Midface lift recovery is generally quicker than facelift recovery.
3. Is a midface lift right for me?
Because this procedure is more invasive than others, it is only suitable for a specific type of patient. You may be a candidate for a midface lift if you meet the following criteria:
4. Is midface lift surgery painful?
Midface lift surgery is usually not painful as patients receive sedation during the procedure. After the surgery, patients may experience minor swelling and bruising, which can be managed with over-the-counter pain relievers and proper aftercare.
5. Will I have scars after midface lift?
Scars from midface lift surgery are typically well-hidden beneath the natural crease of the lower eyelid lashes, resulting in minimal and undetectable scarring.
The mid-face is a cosmetic surgery procedure that can address signs of aging in the midface area, such as sagging cheeks, hollowness under the eyes, and deep nasolabial folds. The surgery involves mobilizing the midface tissues and malar fat pad and releasing retaining ligaments to restore youthful volume and elevate the cheek tissues. Recovery time is usually 7-10 days, and patients may experience bruising, swelling, and minor discomfort. The results of a midface lift are long-lasting and natural-looking. The procedure is different from a facelift, which targets the lower portion of the face. Midface lifts are typically not painful, and any scars are minimal and concealed. Overall, a midface lift may be a suitable option for patients who want to enhance their appearance and achieve a more youthful look.
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