What is a midface lift?

Midface lift is a cosmetic facial rejuvenation procedure designed to address the signs of ageing in the middle section of the face.

The mid-face area refers to the part of the face below the eyelids and around the cheekbones, down to the upper lip. A midface lift procedure involves restoring the position and prominence of a person’s cheekbones, as well as improving the continuum between the eyelid and cheek.

Why undergo a midface lift?

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.

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 impacts 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 help 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 appearance.

In addition, midface lift surgery can be used to correct severe lower eyelid retraction, in cases where there has been a previous disastrous blepharoplasty surgery, or where the patient has trauma or facial nerve palsy. In these patients, midface lift can create better facial symmetry.

A midface lift cannot address all problems in the lower eyelids and will not improve crow’s feet or fine lines and wrinkles in the midface area. If any of these are your main concern, a different procedure, such as BoNT injections or laser resurfacing, may be more worthwhile.

How is a midface lift procedure performed?

The midface lift procedure can be performed in several ways, with incisions in different areas. However, the principle for all techniques 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 lifted to sit higher and more tightly on the facial skeleton and eye socket. The area is then fixed with sutures.

The surgery should take between 1-2 hours, depending on the patient and the extent of the surgery. It is typically performed under general anaesthetic, which means the patient will not be able to feel any pain.

Midface lift can be performed either as an independent procedure or in combination with other types of rejuvenation procedure, such as brow lift, or blepharoplasty.

It may also be performed as a "blepharoplasty plus" procedure to enhance the results of blepharoplasty surgery, by integrating the contours of the eyelid and cheek. This is a highly effective procedure when undertaken in conjunction with blepharoplasty and is performed through the same incision around the eyelid.

Midface lifting is highly effective at restoring youthful volume to the cheeks and creating harmony between the lower eyelid and the rest of the face. It can be an essential tool to augment a lower eyelid blepharoplasty.

How do I prepare for midface lift surgery?

During an initial consultation, the surgeon will discuss your reasons for wanting to undergo the procedure, as well as your medical history and suitability for the 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.

What is the recovery process like for midface lifting?

Recovery following a midface lift is normally between 7-10 days, thus tends to be faster than those who undergo a traditional facelift. It is recommended to rest for a week following the procedure, after which time one can return to normal activities.

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 to help the swelling subside. You will be prescribed appropriate pain relief, although most people will experience only minimal pain. It is best to avoid aspirin or Ibuprofen, as these can increase bleeding or bruising.

The results from midface lifts are immediate, however, the cheek and eyelid are initially “overcorrected”, such that they can appear too high for the first 2-3 weeks. Do not be alarmed - this will settle down into a more natural position.

The procedure is performed as a day case, which means patients do not normally need to stay at the hospital overnight. 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.

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.

Is midface lift surgery painful?

No, midface lifts are not usually painful. Patients will be under general anaesthetic during the procedure, so will not feel pain.

Following the procedure, patients will experience some mild bruising and swelling, but this will subside quickly. Over-the-counter painkillers and following the correct aftercare advice will help minimise any discomfort.

Will I have scars after midface lift?

No, scars are well hidden under the natural crease of the lower eyelid lashes, so scarring should be minimal and not noticeable.

How long does midface lift results last?

The results of a midface lift are long-lasting and permanent, especially when compared to other anti-ageing cosmetic procedures, such as injectable fillers. Patients do not normally need to undergo “top-up” midface lifting procedures.

Most patients are extremely happy with the results of their midface lift procedure, since it will dramatically improve their appearance, particularly when combined with blepharoplasty. When performed correctly, results look natural.

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 midface lift different to a facelift?

Yes, they are two separate procedures. A midface lift treats the middle part of the face, below the eyelids and around the cheekbones, down to the upper lip. A facelift, on the other hand, focuses on the lower part of the face (mouth, neck and jowls). Recovery after midface lift tends to be faster than for facelift surgery.

Is a midface lift right for me?

As this procedure is more invasive than some others, the midface lift will only be suitable for a specific type of patient. You may 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-operative guidance
  • You are in good health