With age and the effects of gravity, the tissues over the cheekbones and below the eyelids begin to sag and lose volume. This makes the cheeks appear flatter, the lower eyelids hollower, and the nasolabial folds deeper. Importantly, descent of the midface also causes disjunction between the cheek and the lower lid. All of this contributes to an older and more tired look.
The mid-face area refers to the part of the face below the eyelids and around the cheekbones, down to the upper lip. In order to address the changes to this area, a midface lift can restore the position and prominence of a person’s cheekbones as well as restore the continuum between the eyelid and cheek.
Midface Lifting is often performed as a “Blepharoplasty plus” procedure to enhance the results of blepharoplasty surgery, by integrating the contours of the eyelid and cheek.
Midface lift can also be performed either as an independent procedure or in combination with blepharoplasty or fat transfer. This is a highly effective procedure when undertaken with blepharoplasty and is performed through the same incision around the eyelid.
Why undergo a mid-face lift?
Descent of the midface is a common ageing change, making the cheeks look flat and sagging. This also disrupts the contour between the lower eyelid and the rest of the face, accentuating eyelid changes, creating more pronounced hollowing and lower eyelid bags.
Midface lift is, therefore, a technique which addresses these changes, making it a popular surgical procedure for people who wish to tackle the signs of ageing.
Traditional facelift surgery has an effect on the lower part of the face and is often not able to significantly address the lower eyelid and upper cheek areas of the face. As such, the midface lift can elevate the fat pad in the cheek (referred to as the malar fat pad), giving the patient greater fullness in the eye and cheek areas, which can create a younger, fresher and more rejuvenated look.
In addition, more extensive midface lift surgery is an important tool to correct severe lower eyelid retraction, such as following former disastrous blepharoplasty surgery, trauma or facial nerve palsy. In these cases, midface lift can create better facial symmetry.
A midface lift is not able to address problems in the lower eyelids, and will not improve fine lines and wrinkles in the midface area, or crow’s feet. If any of these are your main concern, a different procedure may be more worthwhile.
How is the procedure performed?
A midface lift is typically performed under general anaesthetic, which means the patient will not be able to feel any pain.
There are a variety of techniques that can be used, with incisions in different areas. However, the principle is to mobilise the midface tissues and malar fat pad. A series of retaining ligaments are freed. Once the cheek tissues are freed, they are resuspended and elevated in multiple planes to sit higher and more tightly on the facial skeleton and eye socket. The fixation is performed using a series of sutures.
The surgery should take between 1-2 hours, depending on the patient and the extent of the surgery. Many patients choose to combine this procedure with other types of rejuvenation procedure, such as brow lift, or blepharoplasty.
This procedure is very effective at restoring youthful volume to the cheeks and creating harmony between the lower eyelid and the rest of the face. Mid-face lifting can be an essential tool to augment a lower eyelid blepharoplasty.
Preparing for a midface lift
During an initial consultation, the surgeon will discuss your reasons for wanting to undergo the procedure, medical history and suitability for surgery. You will also be asked about any medications you are currently taking, any allergies you might have, smoking habits and other previous surgeries.
Once it has been decided that you are eligible for midface lift, the surgeon will outline what needs to be done to prepare. For instance, if you are taking aspirin or other non-steroidal anti-inflammatory drugs, such as Ibuprofen or Voltarol, you will be instructed to discontinue this for a short period prior to the surgery, as they can increase the risk of bleeding.
You will also be asked to stop smoking for a specified period before undergoing the procedure.
Recovery and aftercare
As the procedure is usually carried out under general anaesthetic, it is important to arrange for someone to pick you up from the hospital afterwards, as it is dangerous to drive yourself home.
The procedure is performed as a day case, which means patients do not normally need to stay at the hospital overnight. Recovery following a midface lift is normally between 7-10 days, thus it tends to be faster than those who undergo a traditional facelift.
It is normal to experience bruising, swelling and inflammation after a midface lift procedure, but this should begin to subside after a few days. Patients are advised to use ice packs on the affected areas for the first 48 hours in order to help the swelling subside. You will be prescribed appropriate pain relief, although the patients typically experience only minimal pain. It is best to avoid aspirin or Ibuprofen, as this can increase bleeding or bruising.
It is recommended to rest for a week following the procedure, after which time one can return to normal activities. Exercise, and other activities that raise the heart rate, can be resumed after 2 weeks.
Patients are advised to not wear make-up or use styling products for the first week after surgery, as this can irritate the healing areas. When washing, gentle patting, rather than rubbing, is best to wash and dry the areas.
Are the results long-lasting?
Most patients are very happy with the results of their midface lift procedure since it often dramatically improves their appearance, particularly when combined with blepharoplasty.
The results are immediate, however, the cheek and eyelid are initially overcorrected such that they can appear too high for the first 2-3 weeks. This will settle down into a more natural position.
The results of a midface lift tend to last longer and are more permanent than other cosmetic procedures, such as injectible fillers. Patients do not normally need to undergo “top-up” midface lift procedures. However, in order to preserve a younger appearance, we recommend maintaining a healthy lifestyle and, if necessary, undergoing other non-surgical procedures as you age.
Is the midface lift suitable for you?
As this procedure is more invasive than some others, the midface list will only be suitable for a specific type of patient. You might be suitable for a midface lift if:
- You have heaviness below your cheeks (sagging)
- You have hollowness under your eyes
- The eye – cheek junction is detached
- You are unhappy with your current appearance and wish to look fresher and more rejuvenated
- You require corrective surgery following previous blepharoplasty, trauma or facial nerve palsy
- You understand the risks and are willing to follow the recommended pre and post-op guidance