Minimally Invasive Lifts of the Face

The Midface Lift with Endotine

The midface lift is a procedure designed to lift and rejuvenate the midface region, or the area in between the lower eyelid and upper lip. This procedure can soften and improve a deep smile line (nasolabial fold) and help to provide additional contour and volume to the cheek region – a classic sign of youth. The midface lift is a procedure that helps restore a more youthful look to the cheek area. This is an area of the face that is not always effectively treated by the traditional facelift procedure. As we age, the cheek area begins to droop. In many cases this results in unwanted flattening of the cheek, which contributes to a tired, aged look. In addition, this can reveal unwanted puffiness below the eyes and deepening of the smile lines as the cheek begins to hang down.

Endotine is an absorbable short ribbon with an expanded end that has hooks. This end is placed under the deep fatty tissues of the cheek and the area is pulled up, securing the upper end of the ribbon to the cheekbone with a screw. All of the materials, including the screw absorb completely within weeks.

The procedure can be accomplished with a very short incision lateral to the eye or at the same time as a lower eyelid surgery is performed.

The midface lift helps reverse these signs of aging by restoring and enhancing cheek volume. Using incisions that are essentially hidden, the underlying cheek muscle and soft tissue are elevated and lifted. The tissue is repositioned higher on the cheek so that the cheek volume and prominence is restored. The midface lift also helps the lower eyelid naturally blend with the cheek.

The midface lift can be done under deep sedation or general anesthesia as an outpatient procedure. It is usually performed in an outpatient surgery center though in rare cases some patients can elect to have the procedure done in the office based setting with local anesthesia. Many patients opt to have the midface lift while undergoing other procedures such as a facelift and browlift. The surgery takes only a few hours with limited swelling and bruising that may last for several days. Patients are advised to sleep with the head elevated and apply ice compresses during the first few days. Any pain that patients experience is well controlled with low-dose prescription medication. Patients are usually able to return to work within seven to ten days after the midface lift and often sooner for those not bothered by any residual swelling.

Overall, the midface lift procedure is ideal for patients who have unwanted drooping in their midface and/or a hollow look under the lower eyelids. These patients often complain of a tired, aged look to the midface. Some have never had significant volume or contour over the cheekbone while others have seen a significant drop in contour due to sagging of the cheek fat pad. Some patients who are considering possible cheek augmentation with a cheek implant may also be candidates for the midface lift. For a procedure that is minimally invasive, the results can be quite dramatic and long lasting.

Neck Lift with Endotine

The new absorbable Endotine ribbons can be used either with a full facelift or in a limited hook the superficial muscles of the neck and to elevate them for a longer lasting and more complete neck lift to tightening of the neck. The ribbons are sutured in and take 8 to 12 weeks to absorb. In its simplest form, this procedure would be performed with a small incision behind the ears and under local anesthesia, with dramatic long term results. I find it especially useful in early relaxation of the face where some skin appears loose under the chin.

Brow Lift with Endotine Fixation

Details coming soon.

Brow Lift with an Eyelid Approach

A small Endotine hook can be used in cases where a full forehead lift is not indicated and only a slight loft of the eyebrows is desired.

The endotine is smaller than the one used on the full forehead lift and takes about 8 weeks to absorb. A big advantage of this procedure is that it can be performed during a blepharoplasty (eyelid lift), not requiring any other scars.