Mid face lift : All You Need to Know About Mid-Facelift (Cheek Lift)

The midface is of central importance in facial aging as this is the first site where its signs manifest themselves. These signs comprise volume loss, deflation, malar prominence flattening, baggy eyes and development of nasolabial and nasojugal folds due to ptosis and laxity. The Mid face lift reverses the ptosis by reposition of the sagging tissues and has even been dubbed the the facelift of the 21st century by Botti and Ceravolo due to its effectiveness.

The Mid face lift has been performed using the transblepharoplasty, trans-oral, trans-temporal or brow-liftlo) approach. The trans-blepharoplasty approach has all the associated disadvantages of lower lid surgery including a canthopexy requirement and risks of asymmetry, scleral show, lagophtalmus and ectropion development.

With the trans-temporal subperiosteal Mid face lift, dissection is extensive, technically demanding, has greater risks and a longer recovery. The dissection plane has to be developed under the superficial temporal fascia and then transitioned to the subperiosteal plane over the zygoma. The surfaces of the zygoma and malar bone then need to be connected through subperiosteal dissection. Subsequent anchorage of the malar tissues are achieved only by suspension of the malar fat pad) and its longevity is questionable. Other alternative procedures such as the minimal access cranial suspension (MACS) lift with a third suture) cause a visible facial scar of 14-16 cm in length.

superficial layer of the temporal fascia. The dissecting plane is then transitioned onto the superficial surface of the superficial layer of the temporal fascia.

The subsequent surgical steps are common to both approaches. As dissection proceeds over the zygoma, the temporal branch of the facial nerve remains protected, it is deep to the superficial layer of the temporal fascia. Both the mid-facial (malar) SMAS and the lateral facial SMAS can be easily reached this way.

While most facelifts treat the sides of the face – in front of the ear and along the lower jaw – a Mid face lift treats the front, giving lifted, youthful cheek contours, rejuvenating the area below the eyelids and smoothing the junction between the lower eyelid and the cheek.

A true Mid face lift is most effectively done via incisions in the lower eyelid and behind the top lip and helps to reverse the earliest signs of aging (sagging cheeks) more effectively than your traditional facelift.

Your surgeon will discuss with you prior to surgery the best approach for you, such as using the lower eyelid route while doing a lower eyelid tuck or blepharoplasty. An alternative approach is to access the cheekbone via an incision in the mouth above the teeth. By carefully lifting the soft tissue, this can be elevated back to its original position over the cheekbone. The tissue is then held in place by a suspension or stitches. This procedure takes about an hour and a half, and results in beautifully restored facial contours.

Often combined with a traditional face and neck lift, this also works as a “stand-alone” procedure and is often seen as the first line of defence in the fight agains aging.