Middle Face Lift

Volume loss in the mid-face area and sagging of the mid-face soft tissues with the effect of gravity during the aging process negatively affect the appearance of the lower eyelid and the central region of the face.

The midface is the central region of the face, which is located on the side of the nose and just below the eyes. When we draw a vertical line downwards from the outer edges of both eyes, the area between these lines is called ‘midface’.

Due to its location, the mid-face region has a functional and aesthetic relationship with the lower eyelid. Individual differences can be observed in the anatomy of this region. The most important of these individual differences are the differences in cheekbone anatomy. Individuals with strong bone structure are resistant to mid-face ageing. Individuals with weak bone structure or weak adhesion strength of soft tissue to bone are prone to mid-face ageing.

Mid-face aging manifests itself with symptoms such as a hollowing in the lower eyelid and cheek transition, visually more elongated appearance of the lower eyelid, the appearance of under-eye bags, prominent tear troughs, and increased lower cheek fullness. Volume losses and sagging in the mid-face area during the aging process can be resolved with mid-face lift surgeries.

General Information for Mid Face Lift Surgery

The loss of the plump appearance and flattening of the surface above the cheekbone is a condition that women in the aging process are uncomfortable with. Midface lift surgery corrects the distorted volume distribution in the mid-face area and increases the sagging tissues to a level closer to that of youth.

In midface lift surgery, the soft tissues in this area are released by going just under the bone membrane. The soft tissue freed from the bone is mobilised in the full upward direction or slightly upward and diagonal direction and permanently fixed to the desired position. Mid-face lift surgery; It is an operation performed under general anaesthesia, lasting an average of 2 to 3 hours, often requiring hospitalisation.

"Mid-face lift is an operation that provides aesthetic benefit in individuals where signs of aging are concentrated under the eyes and in the centre of the face."

Who is a Good Candidate for Mid Face Lift Surgery?

The ideal candidates for mid-face lift surgery are female patients between the ages of 30 and 50. I do not perform mid-face lift surgery in male patients because it creates a ‘feminine’ fullness on the face. The most common indication for mid-face lift surgery; lower eyelid and cheek aging is visually more advanced than the chronological age of the person. We often perform mid-facelift surgery in cases where the lower eyelid is visually elongated, the bags are very prominent, and the cheek mass is both low in volume and low. We can also think of mid-facelift surgery as ‘an extended lower eyelid surgery’. Because, there are hardly any patients who need mid-face lift surgery and do not have deformation in the lower eyelid. The exception to this situation is young women under the age of 30. Mid-face surgery is ideal for patients with structurally, developmentally and genetically weak bone structure in the mid-face or patients with impaired angulation of the bone surface in the mid-face.

"If your lower eyelid aging is far beyond your age, midface lift surgery may be part of the treatment plan."

Techniques of Mid Face Lift Surgery

Subciliary (Eyelash Base) Mid Face Lift

There are 3 basic approaches in mid-face lift surgery. Among these, the most commonly used technique is the ‘subciliary’ approach, in which we reach the midface through an incision in the lower eyelid at the base of the eyelashes. The reason for this is that the lower eyelid and the mid-face area have both anatomical and functional integrity.

After the lower eyelid surgery is completed, we make an incision over the bone under the eye and go down under the bone membrane. Proceeding downwards under the bone membrane, the entire middle soft tissue up to the edge of the mouth is released over the facial bone. The layers of connective tissue holding the midface in place are then loosened and the entire tissue is lifted up as a block. When we perform mid-facelift surgery from the lower eyelid, we fix this liberated tissue to the bone frame under and next to the eye by drilling millimetric holes. In this way, we obtain a very permanent and strong tissue fixation.

Combined Mid Face Lift Technique Performed from the Temple and Inside the Mouth

The second technique of mid-facelift surgery is the combined approach through the temple and mouth. In this approach, the lower eyelid is not used. A 2-3 cm incision is made in the scalp in the temple area and a 2-3 cm incision is made through the mouth corresponding to this incision. The incision is made downwards from the temple and upwards from the mouth and these ‘dissection’, in other words surgical separation gaps, are combined with each other. The freed mid-face tissue is then suspended to the outer membrane of the chewing area at the temple with long suspension sutures. In this technique, the face does not move completely towards the eye, but slightly upwards in a diagonal direction. The advantage of this technique is that the lower eyelid is not opened at all and therefore lower eyelid complications are not seen. This technique is only suitable for young patients.

The disadvantage is that its effect is slightly weaker and it cannot solve these problems in patients with skin/muscle laxity in the lower eyelid. Since it is performed through the mouth, it may also carry the risk of infection.

Endoscopic Mid Face Lift

The 3rd technique used in mid-face lift surgery is the ‘endoscopic’ approach. In fact, the surgery performed is the same as the first 2 techniques, but the tools used are different. In endoscopic mid-face lift surgery, some stages of the surgery are performed with a special micro camera system called endoscope. In this way, it becomes possible to perform the surgery through a smaller incision. By using ‘absorbable’ fixation systems called ‘Endotine’ in endoscopic surgery, we can reduce the need for the incision we make in the mouth.

"Assoc. Prof. Dr. Ozan Bitik has advanced surgical experience in the field of mid-face lift / endoscopic facial aesthetic surgeries, gained from his facial aesthetics upper specialisation and large case series in his own practice."

Preparation Process for Mid Face Lift Surgery

When preparing for mid-facelift surgery, you should inform your doctor about all the problems in your medical history. In patients who use blood thinners (anticoagulants), it is of great importance to discontinue these medications 1 week in advance. Even commonly used drugs such as Apranax, vermidon, aspirin can be considered in the category of drugs that should not be used before mid-face lift surgery because they increase the risk of bleeding. For this reason; do not neglect to inform your doctor and anaesthesiologist about all medications you have to use before mid-face lift surgery.

You should also stop the use of support products such as ginseng, coenzyme Q, multi-vitamin tablets for a while. In addition, it is recommended that you do not consume herbal products containing flaxseed and green tea for a certain period of time.

Smoking, which adversely affects healing and anaesthesia in mid-facelift surgery, is also on the list of things to quit at least 3 weeks before surgery. Since it will be inconvenient for patients to drive after surgery, it is recommended to bring a companion who can drive.

Mid Face Lift Postoperative Process and Recovery

Mid-facelift surgery is one of the surgeries with the longest recovery period among facial rejuvenation surgeries. Swelling on the face after the surgery, especially in the first 1 week, may be to the extent of keeping the patient away from all social activities. Slanted appearance and bruising may be seen in the eyes.

Within two weeks, bruising and swelling gradually decrease, but in the second week, swelling on the cheekbones may still be at a level that may prevent the person from returning to social life.

Patients may need to stay away from work and social life for roughly 4 to 6 weeks after these surgeries. Routine mouthwashes and antibiotic use are required after mid-facelift surgery performed through the mouth. The duration of antibiotic use, especially in procedures performed inside the mouth, may extend from 1 week to 10 days. In surgeries performed from the lower eyelid, there may be a slight burning and stinging sensation in the eye and eye drops are prescribed. Patients are usually hospitalised for 1 night for patient comfort. Stitches in the lower eyelid and hair are removed within 1 week. The patient is called for regular check-ups in the first and 3rd month.

What are the Alternatives to Mid Face Lift Surgery?

Candidates for mid-facelift surgery often consider surgery due to lower eyelid-oriented complaints. Therefore, lower eyelid aesthetic surgeries (lower blepharoplasty) can be an early alternative to mid-face lift surgery.

Although it is not as effective as mid-facelift surgery, the removal of detention bags by entering the inner side of the lower eyelid (transconjuctival lower blepharoplasty) and fat tissue transfer to the upper 1/2 of the cheek mass is an alternative that can temporarily resolve the patient's complaints.

Extended forms of lower eyelid surgery, although not as effective as mid-facelift, can correct the hollowness and under-eye bags in the lower lid/cheek transition and tighten the superficial tissue layers of the mid-face.

Another alternative to mid-face lift surgery is the use of prosthesis (implant). This form of treatment, which is especially suitable for male patients with weak skeletal structure, supports the skeletal structure and creates a masculine fullness in the mid-face area. The use of implants can be an alternative to mid-face lift surgery, or it can be used as a complement to the surgery to further emphasise the results of mid-face lift surgery.

We frequently combine mid-face lift surgeries with face lift, neck lift, lower and upper eyelid, and fat injection.

Mid Face Lift Surgery Prices

Mid-facelift fees vary according to the expertise of the doctor, the techniques to be used, combination surgeries and support applications. The combination of the best applications that can meet the needs of the person is very important both in terms of the result and patient satisfaction. However, since everyone has a different facial structure and complaints, mid-face lift prices vary according to the person.

You can contact Assoc. Dr Ozan Bitik for information about midface lift operation fees and for examination.

For more detailed information about midface lift surgeries, you can access www.yeniyuzyenihayat.com, which is one of the most comprehensive Turkish resources on the internet in the field of facial aesthetics, created by Assoc. Dr Ozan Bitik by clicking on the BLOG section of our website.