The Mid-Face Lift
Getting Your Bloom Back

Which factors create the look of an "aging" face?

• Loss of subcutaneous fat.
• Bone loss.
• Gravity.

Three Enemies

These three enemies steal the fresh, "blooming" look from our faces and gradually replace it with a tired, sometimes wasted appearance. Particularly at risk is the mid-face area. When the mid-face falls, the result is jowls and nasolabial folds (those vertical lines from mouth to nose). When it loses subcutaneous fat and bone, the face begins to sag.

Multidimensional

Because these problems are multidimensional, we've developed a multidimensional approach to correcting them. We have four separate methodologies for correcting the mid-face:

• Repositioning of the deeper facial tissue (surgery).
• Implants (surgery).
• Fillers (Juvederm, Restylane, Radiesse).
• Fat transfers.

Used separately or in combination, they bring back the contours of the face as it used to be, before the three enemies took their toll.

They're so good at restoring volume that we now ask our mid-face lift patients to come with photographs of themselves at a younger age. We use these as a guide to their multidimensional restoration, mapping areas that need fullness and designing a more nuanced, thoughtful version of their faces.

In recent years we've perfected products and techniques for repositioning facial tissues. We can now elevate the soft mid-face tissue, repositioning it upward towards the eyes, and fixate it in place until it re-adheres naturally to the bone.

A mid-face (Cheek Lift) "suspension," as we call it, can do more than add fullness. The key to modern facial rejuvenation is repositioning the cheek fat pad to its youthful position over the cheekbone. We us small hidden incisions to support and lift these structures. Similar procedures have been described as the MACS lift.

Smile Lines and Jowls

Or, if your smile lines have deepened and you've begun seeing signs of jowls, a mid-face suspension will work wonders. Lifting skin in the cheek area automatically lifts it in the lower face, thus softening the nasolabial folds and lifting the jowls to improve the jawline.

Everyone knows that bones gradually shrink as we get older. The bones of the face -- the "pillars" formed by chin, cheek and jawbones - tend to shrink or lose definition starting at mid-life.

Today we use a variety of volumetric implants to bring these features back to an earlier time. Essentially we re-sculpt the face with those classic qualities that result in a more photogenic look. A weak chin contributes to the aging face. A simple chin implant can create a more youthful appearance.

The simplest and least expensive method of facial contouring is through the use of temporary injectable fillers.

Restylane and Juvederm work well for this. Both are made from hyaluronic acid, a substance that occurs naturally in our bodies - it's part of what creates volume in the skin. Since this product does not involve the use of foreign substances, allergies are extremely rare and a skin test is not required. Radiesse (calcium hydroxy apatite) is made of a substance that stimulates you own natural collagen for long-lasting results, for up to 2 years.

The Upside

This is performed in our office, with or without a topical anesthetic or nerve block, and the procedure takes about 5 to 15 minutes.

Restylane and Juvederm are used to treat fine lines, wrinkles and superficial nasolabial folds. Radiesse is used deeper in the tissues. Radiesse treats deep nasolabial folds and can be used to correct bone loss. Rather than using a synthetic surgical implant, Radiesse injections can build up the cheekbones and smooth the jaw line.

The Downside

This is not a permanent solution. It will wear off in 1 to 2 years.

Facial fat replenishing is another technology that's come of age in recent years. By taking fat from areas of your body where you don't want it and re-injecting it into your face, we can safely add volume in strategic areas such as the nasolabial folds (mouth to nose folds), undereyes, cheeks, chin, jawline, temples, etc. Injecting fat into the cheek area is a very simple, noninvasive way of restoring a youthful look.

The Upside

Often fat grafts will last longer than fillers.

The Downside

Unfortunately, patients differ in the extent to which they are able to maintain fat grafts over time.

A Caveat

The procedure doesn't work for smokers. Fat transfers can't survive the added stress of vascular constriction. People on blood thinners also get poor results, because the drugs induce bleeding into the transfer area, killing fat.

Today, many cosmetic surgeons like myself regard restoring the mid-face as the best strategy for maintaining a "blooming" look in mid-life. Often mid-face restoration can postpone the need for more comprehensive surgery (a facelift).

Why not come in for a consultation? You'll be surprised at the impact these simple procedures can have.