As we age, 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. Over time, the mid face (cheek soft tissue pad) drops producing deep nasolabial grooves (folds outside of the nose and mouth areas), and sunken cheeks. The face goes from being heart shaped with the volume of the cheeks over the cheek bones, to being more square shaped and jowled. 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 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”.
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 mid face. 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.