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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