Mid Face Lift / Cheek Lift
Endoscopic Facelift

Introduction

Description
The midfacial region refers to the middle third of the face, corresponding roughly to the facial region between the lower eyelid and the upper lip. A midface lift addresses this facial region, with the goal of lifting and restoring the midfacial soft tissues to their original position in relation to the bony foundation below.

Midface Lift Surgery
The Mid Face Lift is usually performed under anesthesia in the operating room. In most cases, a midface lift can be performed through small incisions using surgical endoscopes. These incisions are concealed in the hairline, and are similar to incisions used for an endoscopic brow lift (area shaded light red in diagram). Mid-facial soft tissue (stippled blue in diagram) can be lifted and repositioned to restore a more youthful appearance to this region. This type of approach is sometimes referred to as a 'scar-less' facelift, because all incision sites are conealed within the hairline.

Dr. Pearson's Philosophy Regarding Facial Rejuvenation
Dr. Pearson understands that people want to look like themselves, only better - that is, the best version of themselves. The goal of facial rejuvenation is to retain your unique facial features, while simultaneously minimizing those unfavorable characteristics which contribute to the appearance of perceived aging and loss of vitality. In Dr. Pearson's opinion, the ultimate goal of facial rejuvenation services should be to restore a refreshed and rested appearance, while maintaining a natural and appropriate look.

The goal of a Mid Face Lift is not to look different, just better. In particular, one should never look 'done' or 'surgerized.' as a result of plastic surgery. In order to achieve that, the surgeon needs to avoid the tell-tale signs of surgery such as overly-tight or pulled appearance, poor incision site design and/or scars, or an overdone appearance in general.

A superior Mid Face Lift result is usually not even perceived as having resulted from surgery. Onlookers usually comment that our patients look refreshed, or especially well-rested as if having recently returned from a vacation without assuming that it involved surgery.

We are grateful to our many patients who have generously contributed their before and after photos so that others may learn. Please view our photo gallery to see samples of Dr. Pearson's work. Pictures may speak more clearly than words what we mean by 'the best version of yourself.'

The Aging Process
As part of the normal aging process, the soft tissue overlying the cheek bone (malar eminance) loses volume and descends in a predictable manner. As these soft tissue changes progress, the lower orbital rim becomes visible producing the so-called ‘double bubble’ deformity characteristic of aging.

Viewed from the 'three quarter' perspective, a youthful midface is characterized by a gentle convexity of the lower eyelid, which is connected via a smooth concavity to the larger convexity of the front of the cheek.

Age-related changes cause separation of the soft tissue covering from the lower orbital rim, thereby exposing its contour. The lower eyelid fat may begin to bulge to some degree, accentuating its formerly gentle convexity. Just below, cheek fullness is lost as part of age-related 'deflation' of the midface. The soft tissue of the midface and cheek region sags and descends, accentuating the apparent depth of the nasolabial fold. Together, the cheek deflation and descent contribute to a relative flattening of the cheek when viewed from the three quarter perspective. In addition, the single youthful convexity of the cheek becomes a double convexity consisting of the bony lower orbital rim above and the descended soft tissue of the cheek below. When viewed from the front, a shadow is cast in the concavity between the two convexities described above. This shadow appears as dark circles underneath the eyes, and may be interpreted by others as a sign of tiredness, loss of vitality, and aging.

The youthful midface is characterized by a gentle convexity of the lower eyelid, which is connected via a smooth concavity to the larger convexity of the front of the cheek.	As part of the normal process of midfacial aging, cheek deflation and descent contribute to a relative flattening of the cheek when viewed from the three quarter perspective.

Candidates for Mid Face Lift Surgery
You may be a candidate for a midface lift if you have noticed an unsatisfactory loss of fullness from your cheeks, a tired appearance to your lower eyelids or the development of the ‘double-bubble’ deformity described above. Upon review of photographs of yourself from your youth, you may notice a change in position and elongation of your frontal cheek relative to your eyes, sometimes including the development of dark circles underneath the eyes owing to the descent of the cheek and the exposure of the lower orbital rim.

The Mid Face Lift Procedure repositions the sagging midfacial soft tissues to a higher, more favorable position, reminiscent of the youthful cheek.	The goal of the Mid Face Lift procedure is to restore the gentle convexity of the midface.

Complementary Procedures
Often a Mid Face lift is combined with a forehead lift or browlift and uses the same incisions within the hairline. It may also be combined with lower blepharoplasty to address the bulging eyelid fat and now redundant lower eyelid skin which contributes to the aged appearance of the lower eyelid-midfacial complex. Fat transfer (also called fat grafting) may be performed at the same time as midface lift surgery. This technique uses your own living fat cells from another body site to restore regions of facial volume loss to more youthful proportions. A skin resurfacing procedure may be performed to improve skin surface changes.

Possible Non-surgical Alternative Treatments
For early or subtle changes, nonsurgical methods can be employed by Dr. Pearson to improve the appearance of the midface. Volumizing fillers can replenish some of the midfacial volume that is typically depleted with aging. For more significant changes or for those patients seeking a more dramatic improvement, a midface lift is considered.

Recovery after Mid Face Lift Surgery
Following a midface lift, you can expect a few days of soreness which is well controlled with oral pain medications. Sutures are typically hidden in the hairline and are removed after a week. Swelling and bruising generally subside by 14-21 days. You can resume most normal activities after a couple of days, except for intense exercise, which may be resumed at about 3 weeks. Most people are able to return to work in 2-3 weeks.