Midfacelift (synonym: midface lift) is a surgical cosmetic procedure designed to sculpt the midface, the area between the eyes and the corner of the mouth. In the area of the middle third of the face, typical signs of aging result in an unsatisfactory appearance that many patients do not like and can lead to decreased self-confidence. Overall, these age-related changes result in a sunken, narrow, and hollow-cheeked expression in the midface:
- Pronounced nasolabial folds – wrinkles between the nose and lips.
- Sagging of the lower limbs
- Skin slackening
- Convexity of the bridge of the nose
- Ptosis (lowering) of the cheek fat
- Rarefication (reduction in substance) of the nasal skeleton.
- Reduction of subcutaneous adipose tissue (subcutaneous fat) – this leads to sunken cheeks.
- Shrinkage of subcutaneous fat tissue in the nose area.
- Widening of the nose
- Lengthening the nose
Overall, the midfacelift involves lifting the sunken and sunken structures (ptosis concept) using an aesthetic surgical method.
Indications (areas of application)
- Pronounced bags under the eyes due to lowering of the tissue.
- Pronounced nasolabial fold due to lowering of the tissue
- Sunken cheeks due to lowering of the tissue
Contraindications
Absolute contraindications
- Known allergy to anesthetics or local anesthetics.
Relative contraindications
- Known tendency to convulsions (epilepsy)
- Taking anticoagulants (anticoagulant medications).
- Too high expectations of the patient for the outcome of the operation
- Severe heart disease
- Severe lung disease
- Severe liver damage
- Severe kidney damage
- Tendency to thrombosis (thrombophilia)
Before surgery
Before surgery, an intensive medical history discussion should be conducted that includes the patient’s medical history and motivation for the procedure. The procedure, any side effects, and the consequences of the surgery should be discussed in detail. Note: The requirements of the explanation are stricter than usual, since courts in the field of aesthetic surgery demand a “relentless” explanation. Furthermore, you should not take acetylsalicylic acid (ASA), sleeping pills or alcohol for a period of seven to ten days before the operation. Both acetylsalicylic acid and other painkillers delay blood clotting and can lead to unwanted bleeding.Smokers should severely limit their nicotine consumption as early as four weeks before the procedure so as not to jeopardize wound healing.
The surgical procedure
The procedure is performed under either general anesthesia or analgesia (painless twilight sleep under pain blockade). Access to the midface is the same as for a lower eyelid lift: the incision is made under the edge of the eyelid with extension to the side in a naturally existing smile crease. If the condition is pronounced and requires more elevation, the incision in the smile crease can be extended to the region of the temporal hair. Through the incision, the surgeon inserts his instruments and carefully dissects the soft tissues of the midface and additionally the periosteum so that they can be carefully lifted from the base. The tissue is now placed under slight tension, moved up about 2 cm and sutured, and excess skin is also removed. It should be noted that it is not the skin but the tissue layers underneath that are placed under tension in order to achieve a permanently beautiful result. The suture later disappears into the natural smile crease or temple region, as already mentioned. This surgical technique visually shortens the lower eyelid again, the bags under the eyes disappear in depth, and the nasolabial fold is smoothed. In addition, the cheek region regains volume and thus a youthful contour. The effect can be additionally supported with a cheek implant (cheekbone reinforcement). Whether this is necessary depends on the initial findings. Often, the procedure can be combined with a lifting of the outer eyelid angle, or with a lifting of the brow region, since tissue has usually already sagged here as well.
After the operation
After surgery, the patient will receive a bandage for a week to hold the scar in place and support the tissue. Swelling is usually present and should be cooled with cooling pads. Exercise and direct sunlight on the scars should be avoided for about a month. Reddening of the scars is normal and recedes after a few weeks.
Possible complications
- Allergic reactions – e.g., to the anesthetic.
- Tearing of the wound edges
- Dog Ears – this technical term refers to excess skin that develops at the surgical scar and is removed for aesthetic reasons in a second operation
- Postoperative bleeding
- Hematomas (bruises)
- Keloids – increased scarring
- Edema – swelling
- Pain, feeling of tension
- Sensory disturbances in the surgical area
- Thrombosis – vascular disease in which a blood clot (thrombus) forms in a vessel.
- Wound healing disorders due to circulatory problems.
- Wound infections
Benefit
After a midfacelift, the entire face appears younger, fresher and has more tension. The cosmetic procedure effectively corrects annoying signs of aging and gives your face a cheerful expression.