Not to be confused with a standard face lift, where excess skin and tissues are removed, a mid-face lift is more related to fat transplantation, as no tissues are excised; instead, tissues are merely transplanted, resulting in a recontouring of the face.  Also known as a “centrofacial lift” or a “facelift without scars”, it results in a more full cheekbone area while lifting the jowls and correcting the deep folds of the cheeks. It is a fascinating operation.

I find that most people have some difficulty in understanding the concept of mid-face lifting. The main problem is that it shares common words for something that everybody understands, which is the traditional facelift, which lifts and removes tissues. A mid-face lift, however, uses the normal fat pads of the face to reshape the original contour as it existed in early adult life. The main fat collection is known as the “buccal fat pad” and exists in the cheek area as a “Y-shaped” structure with the foot of the Y in the jowl area.  As everyone has observed, the jowls become more pronounced with time and is one of the hallmarks of the aging process. The upper two points of the Y then extend into the temporal area, or temple, and the other into the “canine fossa”, the space above the canine teeth.

With time, this complex fat collection tends to sag, drawing the cheek-folds and the mouth with it; this produces that aged look. A mid-face lift utilizes that same fat, placing it where it once was at a much earlier time, and hence rejuvenates the facial contour. This is why I consider it such a fascinating operation.

The procedure is carried out through an incision in the mouth above the canine teeth and through another incision in the temple. After freeing the cheekbone of tissues structures, a special device is introduced which then suspends these freed tissues. While sounding complicated the process is actually quite simple. Who is a proper candidate for this? Somebody who has a good neckline but has flat cheekbones and full jowls is the ideal candidate. The procedure can also be combined with a traditional facelift if loose neck structures need to be corrected.

The procedure is performed under general anesthesia and takes about 3 hours. Recovery is similar as with a traditional facelift; in addition, I utilize the fibrin glue Evicel as I do with a facelift to reduce bruising and speed recovery. Since there are no visible scars this is sometimes called a “facelift without scars”.