What is a Midface Lift?
Also known as cheek lifts, midface lifts are designed to give the natural fullness back to the cheeks, to improve the groove that occurs with aging below the lower eyelids and lift the mid and lateral part of the face. This is best illustrated photographically in the following before-and-after photographs.
Plastic surgeons have concentrated on upper and lower blepharoplasties and lower face and neck lifts and have long ignored the midfacial structures. Dr. Patel, together with others studied this midfacial ages and developed and published surgical techniques which have helped improve the results of facial rejuvenation.
"Well, the last time I had a picture taken I could hardly see my eyes because of the weight of heavy eyelid. Then I paid attention to how I was actually using my eyes and I really noticed when I was looking at anything especially the computer I was straining my forehead to see better. Since I have had it done I no longer have to lift the forehead and tilt my head to see. It is amazing! I love..." D. Rock 63 Yrs Old with Fat Droopy Eyes - Salt Lake City, UT
The beauty of the midface?
This nicely illustrates how our "Hammock Lift" approach to the midface recreates the malar fullness (mound) and also created the sub-malar hollow. This gives structure to the face. Even in an older patient, elegance is returned to the face!
It is understandable that people don't like heavy brows, or frown lines, or baggy eyelids or jowls or loose necks. What is often forgotten by people and by plastic surgeons alike is the importance of the midface and how it gives definition to the face. Analysing what constitutes beauty in the middle of the face allows one to understand why we instinctively know when a face we look at looks beautiful.
1. This is the fullness so important in the brow. There has been a tendency to remove brow fat pads when plastic surgeons perform upper blepharoplasty or browlifts: this is a mistake. We, on the other hand, always augment the brow with fat grafts during surgery to give this nice fullness back again. Aging results in decompression of the brow fat pad.
2. This is the all-important malar mound or fullness. It has a particular shape and position that must be understood by the persnickety plastic surgeon if he/she is to achieve the best results.
Just below this malar fullness sits a hollow that is possessed by all models! Look up photographs of any female models and you will be struck by the consistency of the presence of the malar fullness and the sub-malar hollow. We therefore try to recreate both of these, even in patients who never had them as it just makes the face more beautiful!
3. This is the sub-malar hollow discussed above.
4. The submalar hollow leads to the firm convex jawline. Therefore, the midfacial anatomy is multicontoured: the face or the mid face should not be just pulled as has often beendone. These contours, hills and valleys must be constructed to give the ideal result.
Am I a Candidate for a Midface Lift?
Most midface lifts are performed in conjunction with lower eyelid blepharoplasty. Just as brows and upper eyelids function as a unit, so do the lower eyelids and cheeks. Indeed, a common combination to improve the appearance of the upper and middle part of the face is to combine a brow lift with upper and lower blepharoplasty and cheek lifts: the specific way of doing this was designed by Dr. Patel (called the Hammock Lift) who has presented the technique at international meetings and published this technique in plastic surgery journals.
How will I be Assessed?
It is always useful to review your photographs from younger days as we all age similarly but differently! In particular, the prominence of the cheeks depends not just upon the bony prominence (which decreases with time), but also the degree of malar fat and relation of the cheeks to the angle of the jaw. This combination of structures needs to be assessed, both, on the photographs as well as on you to determine how much of an improvement would be achieved with a midfacial lift.
What other Procedures May be Performed with a Midface LIft?
Fat grafts and surface lasers are often used together with midface lifts to give the best results.
Patients may benefit from attention to upper eyelids (upper blepharoplasty), forehead and brow lifts, cheek lifts, face and neck lifts, fat injections, laser resurfacing and other facial and neck procedures. Please do not hesitate to ask us questions about any other aspects that may bother you. We always remind all our patients: no one NEEDS cosmetic surgery. But if you decide you would like to see an improvement in any aspect of the face, we will pay close and careful attention to ensure only appropriate and safe procedures are performed.
In the presence of a deep groove and ptosis of the cheek, it is unwise to perform just a lower blepharoplasty: your results will be ho-hum! In such instances, a midface elevation with fat transfer combined with a lower blepharoplasty gives the best result. If this applies to your anatomy, it is
important to identify the factors before undergoing surgery!
Understanding the "Hammock Lift" with a case study
A split-face image showing the right side of the face before and the right side of the face flipped on the left after surgery so a direct comparison may be made. The improvement in the lip wrinkles (smoker's lines) and skin is from the use of fractionated CO2 laser at the same time as the Hammock Lift procedure
PATIENT CONCERNS
This patient was bothered by "my face". However, specifically, she wanted an improvement in her forehead, upper eyelid looseness, lower eyelid bags, lip lines and jowls. But she did NOT want a facelift and necklift just yet.
HAMMOCK LIFT PERFORMED
This is a combination of a forehead/brow reshaping combined with upper and lower blepharoplasty and a technique of midfacial tissue repositioning we have developed with not only recreates the cheek fullness of youth whilst reducing the lower fat "bags", but also helps with lower facial and jowl improvement. We routines use skin treatments (lasers, peels, etc) to improve the overall improvement of the face.
This is not meant to be a replacement for a lower face and necklift which is what is needed to get the best jawline and neck, but this combination of procedures we have been using on our patients allows us to manage the face in two halves: the "Hammock Lift" first, which gives excellent results. Followed by a lower facelift and necklift when the patient is ready.
Fat grafts and surface lasers are often used together with midface lifts to give the best results.
The Hammock Lift
"My Hammock Lift is exactly what I needed, but did not know! Dr. Patel explained to me how the Hammock Lift improves the upper two-thirds of the face, including the forehead lines, the brows, the upper and lower lids and the cheeks. I also got an improvement along my jawline which I am thrilled with as I plan on having a lower facelift and necklift later but this has already given me a terrific improvement. I have sent my two sisters to him! Brilliant surgeon: can't speak highly enough about him or his excellent team."
J. Stevenson "Top Marks" - Park City, UT
What kind of results can I expect after a Midface Lift?
A picture tells a thousand words:
The aim is to achieve a congruous balance between the forehead, the upper eyelids, the lower eyelids and the cheeks. A nice benefit of a well-performed cheek lift is the improvement one sees in the lower part of the face. Whilst the midface lift is no substitute for a lower facelift and neck lift, in those patients
that don’t (yet) need a lower facial procedure, it is an excellent “side-benefit”.
"I had a excellent eye lift done by Dr. Patel. He knows what he is doing and is very pleasant. Dr.Patel was easy to get an appointment and he works with you. The office staff was very pleasant and made you feel calm." D. Gull Highly recommended for eye lift surgery - Salt Lake City, UT