Who is a candidate?

Patients with prominent nasolabial folds (the cheek tissue next to the nose and upper lip) and associated loss of cheek volume may be candidates for a midface lift. 

What are some benefits of the midface lift?

The midface lift is designed to soften the nasolabial fold (the cheek tissue next to the nose and upper lip) and enhance the cheeks, resulting in restoration of a more youthful heart-shaped facial contour.

The midface lift more directly addresses the midface than a conventional face and neck lift.  The procedure can be done at the same time as a browlift and/or face and neck lift or as a separate procedure. Some patients elect to treat mid-face descent "pre-emptively" as it is just beginning to occur (mid- 30's to mid-40's), while others become more motivated to undergo lifting procedures after changes in the cheeks are more readily apparent (late 40's and beyond).

What causes these changes in my face?

As we age, the structures that support the cheek soft tissues also weaken over time resulting in  loss of cheek volume with a corresponding increase in prominence of the nasolabial fold. How is the midface lift performed?

Dr. Holcomb performs an endoscopic-guided midface suspension procedure using Coapt Systems ENDOTINE Midface™ multipoint fixation device.  The procedure requires a small incision in the hair-bearing temple as well as a small incision under the upper lip.  The incisions are carefully connected in a very deep plane immediately above the bony structures and the Coapt Systems ENDOTINE Midface™ multipoint fixation device is then placed into position to elevate and reposition the cheek soft tissues.  Early on the procedure is adjustable and reversible (before the soft tissues heal in the new position).  After the soft tissues have healed in the new position, the ENDOTINE Midface™ multipoint fixation device gradually dissolves.

Medical evaluation for a mid-face lift:

Important considerations include, but are not limited to previous surgery, smoking history and facial nerve function. 

Previous surgery:

Patients who have previously undergone facelift surgery who have persistent concerns about cheek volume and nasolabial fold depth are often good candidates for a midface lift.   Prior midface fracture repair may be a contraindication for the procedure.

Smoking history:

Smoking has a number of negative effects on the wound healing process.  The main concern relates to diminished oxygenation of the tissues that results from both decreased oxygen-carrying capacity of the blood and impaired blood flow to tissues through damaged blood vessels.  Individuals who smoke regularly are at increased risk for impaired wound healing after surgery.  We strongly encourage individuals motivated to undergo facial plastic surgery to stop smoking for 2 weeks before and 2 weeks after surgery if not altogether.  

Facial nerve function:

The facial nerve exits through a small opening in the bone below the ear canal and travels through the parotid salivary gland en route to the various muscles of facial expression (muscles that control movement of the face).  Different branches of the nerve control movement of the brows, enhance eye closure and control movement of the cheeks and lips as well as activity of the sheet-like muscle in the neck (platysma).  While the various branches of the facial nerve are relatively close to the "action" during a midface lift, it is not common for branches of the facial nerve to be injured during these procedures.  If weakness does occur in a particular area (e.g. forehead) it is usually temporary.

What is the recovery following the mid-face lift?

The initial recovery period for midface lift or any type of facial plastic surgery is 1 week.  Any sutures or clips placed during surgery are removed on or before the 7th day after surgery.  Mild to moderate swelling of the cheeks is common following surgery.  The swelling diminishes rapidly over the first and second week following surgery.  Some patients may develop bruising following surgery.  While the bruising diminishes gradually over several weeks following surgery, the healing process (including resolution of bruising) may be enhanced significantly through the use of platelet rich gel.