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Out of all the people I've met that wanted facial plastic surgery, there was not
a single one that desired a 67% improvement in his or her appearance. Two-thirds
better? Of course, that sounds ridiculous, but that's exactly what we've been
doing for years! In the past, cosmetic facial surgery has concentrated on
concerns of the forehead and eyelids (the upper third of the face) with
procedures such as browlifts and eyelid lifts. Jowls and turkey neck of the jaw
and neckline (the lower third of the face) were corrected with facelifts and
necklifts. But until the mid face lift was developed recently, there had been no
technique to adequately address the multi-faceted changes that occur in the
middle of the face, leaving a tired and aged appearance despite the best efforts
to improve one's look.
To understand facial aging better, let's take a look at the mid face. Over time,
gravity, repeated muscle contraction, and lifestyle choices cause skin, fat, and
muscle to move downwards, particularly in the area between the lower eyelids and
the mouth known as the mid-face. An improperly positioned mid-face can
accentuate the aging changes around the mouth and chin. Sagging of the cheeks
results in apparent puffiness of the lower eyelids, under eye circles, an
indentation in the upper cheek region, and a deepening of the the line between
the nose and the corner of the mouth.
With traditional facelift surgery, the tissues are pulled to the side of the
face through incisions made along the hairline, and in front of and behind the
ears. In contrast, the mid face lift can be performed through incisions made
only inside the eyelid and provides the ability to elevate the cheek skin, fat,
and muscle vertically to compensate for gravity's downward pull. Because of
this, a mid face lift is sometimes referred to as a "vertical lift" or "cheek
lift".
While there are five or more approaches to the mid face lift, my preferred
method is through the inside of the eyelids and sometimes the mouth thereby
avoiding any external scars. One has to be careful with this approach, however,
not to create an undesirable outcome such as pulling down of the lower eyelid,
known as eyelid retraction. This procedure should, therefore, be performed only
by an experienced surgeon, competent in advanced lower eyelid and facial
surgeries.
During the operation, the tissues are lifted and then suspended to deeper
structures to prevent early recurrence of cheek descent. Regardless of
technique, the ultimate goal of the mid face lift is to restore the natural
convexity and fullness of the lower eyelids and cheeks, reposition cheek fat to
its original position, and provide fullness to the midface. Ultimately, this will
produce a natural and youthful appearance to the face without an overdone or
pulled look.
In addition to elective or cosmetic surgery, a mid face lift is sometimes
performed for facial reconstruction. It can be used to repair eyelids that turn
out from birth defects, scarring, or previous cosmetic surgery. A mid face lift
can correct eyelid retraction from tumor, thyroid eye disease, trauma, or nerve
and muscle disorders. It is also used to suspend a cheek that may have been
weakened or paralyzed from stroke or Bell's palsy.
A mid face lift can be done under local anesthesia or IV anesthesia, and
typically takes two to three hours. Some individuals with less extreme sagging
may need only a minor procedure of about an hour's duration to reposition fat
around the eye (called a SOOF lift). A mid face lift is often combined with tear
trough or cheek implant insertion, fat transfer surgery, eyelid surgery, or with
skin rejuvenating procedures such as a chemical peel or laser resurfacing. A mid
face lift will not address skin wrinkling, an aging neck, upper eyelid concerns,
or forehead wrinkling and drooping.
Surprisingly, it took centuries or more of aesthetic facial plastic surgery to
realize that the middle third of the face was being overlooked. Through careful
analysis and understanding of the specific direction in which the face ages, the
mid face lift originated and was further developed. Now that the mid face lift
is an option for facial enhancement, you can be sure of the most natural, most
complete rejuvenation to date.
Dr. Jonathan Hoenig, is founder of the California Institute of Cosmetic
Surgery in Los Angeles, California where he provides the most advanced and
innovative techniques in facial plastic surgery and facial rejuvenation today.
To learn more about facial plastic and reconstructive surgery, visit us on the
web at:
www.la-plastic-surgery.com
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