Q: I have heard about the new mid-facelifts. How do these differ from a standard facelift, and which procedure is better?

A: Mid-facelifts are relatively new but some surgeons have been performing them for 10-15 years. Both types of facelift procedures are designed to turn back the hands of time, but each addresses different aspects of the aging process. A standard facelift is still the ideal procedure to tighten a loose neck and to help with jowls.

While the mid-facelift is indeed a relatively new procedure, it address an age-old problem: the drooping and hollowing of the cheek areas below the lower eyelids, which create a so-called “tear trough” deformity. The mid-facelift can be done as an isolated procedure to freshen a face in the late 30s or 40s that is showing early signs of aging. It can also be combined with a traditional facelift in an older person, or as an isolated procedure in an older patient who has had a traditional facelift but the mid-face was not addressed.

The traditional facelift is wonderful for dealing with jowls and the neckline. It was designed to pull the skin and superficial muscles backwards to minimize the jowl and to tighten the neck areas, but this procedure does not address the elongated lower eyelid and the hollowness in the mid-face region. As a matter of fact, the tension required to pull the cheek tissues backward actually flattens the mid-face region, further exacerbating the unnatural look! In some instances of minor neck laxity, the neck may be tightened by inserting a variety of threads beneath the surface and restoring neck laxity. Such minimal-incision thread procedures will not give the patient an optimal result if significant laxity is present with significant skin excess. 


The new mid-face or cheek lift procedures specifically address this central facial hollowness and work to restore a curvilinear, youthful facial appearance. One of the beauties of a mid-facelift is that it can be done through short incisions hidden behind the hair line and through a tiny stab wound in the fold between the cheek and the upper lip (just large enough to let us insert a few very long needles) which heals without a visible scar.

Through these access incisions, the surgeon can elevate the tissues that have drifted downward back into a more youthful position, using suspension sutures. The aging face can thus be sculpted tension-free to recreate the soft and graceful curves of youth. The mid-facelift will not alter your jowls or neck laxity, so if these are an issue, a traditional face and neck lift will also have to be performed to achieve optimal rejuvenation.

The midface lift, along with micro-fat grafting of the tear troughs, are most frequently performed as adjuncts to a traditional lift. Some patients, usually those who are younger with aging limited to the mid-face region, or those who have already had a traditional facelift, will benefit from a mid-face/cheek lift as a sole procedure. Others may best be served with a mid-face lift combined with a traditional lift or other associated procedures in order to achieve the optimal result!

Facial rejuvenation is at the top of the list of the most common aesthetic surgical procedures. Most people feel physically and mentally vigorous and energetic long after their appearance has begun to deteriorate due to aging. A face, neck, brow or mid-facelift procedure is designed to provide you with a rejuvenated appearance. The degree of improvement achieved depends on the severity of the initial deformity, the age of the patient, tissue elasticity and the recommended procedure.

It is important to seek a surgeon who is well-versed in all of the options, so that a customized plan can be developed for your concerns.

Author Bio: Dr. Bunkis MD, FACS of Orange County Plastic Surgery is a Harvard trained, Board Certified Plastic Surgeon and has 30 yrs of surgical expertise. Call Orange County Plastic Surgery at 949-888-9700, email your questions to info@ocps.com or visit ocps.com for more information. Serving Irvine, Newport Beach, Mission Viejo, Laguna Beach, Rancho Santa Margarita and surrounding cities.

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