A number of patients have asked me, “Why don’t you recommend a mid-face lift as one of my options when we talk about fillers and face lifts?” Occasionally I will but I tend to avoid this operation. Here’s why.
We have many different ways of lifting the face –
- Brow lifts
- Upper and lower eye lid lifts
- Mid-face lifts
- Lower face lifts
- Central neck lifts
- Standard neck lifts
All of these have changed over the years and have been improved by various refinements of technique. Many have developed into several different operations. But the new advances of Botox, soft silicone implants and off-the shelf fillers have made the Mid-Face Lift less useful.
- Botox corrects the frown lines around the eyes much better than the mid-face lift.
- The mid-face lift can easily exaggerate crows’ feet.
- Fillers give fullness to the mid-face much faster and more safely than mid-face lifts.
- Mid-face implants give support to the mid-face with less risk than the mid-face lift.
- The mid-face lift is notoriously slow to heal and more prone to complications than other facial lifts.
The complications caused by Mid-Face Lifts
- An incision under the lower lid that extends beyond the eye is usually used.
- This incision takes at least 3 months to fade. The scars of other facial lifting procedures are much less noticeable from the start.
- The pull of the mid-face lift on the lower eyelid can cause ectropion – a pulled down lower lid which is both unsightly and difficult to correct.
- Soft solid silicone mid-face implants have their own risks but will not affect the appearance of the eye while giving lift to the middle of the face.
- Because of gravity and difficulties securing the mid-face lift, results tend to be less durable than other lifts.
- The mid-face can be lifted using an incision in the temple and entering the mid-face from the side. But this is also difficult approach with a significant risk of nerve injury if not done with precise accuracy.
There is always a balance in surgery, especially facial cosmetic surgery, between the safest operation and the most effective one. We want facial operations to be effective but we also want a very low risk of prolonged unsightly recovery, permanent nerve injury and eye disfigurement. We have a good balance for all other face lifts but not the mid-face lift. So for now, most plastic surgeons feel that for the mid-face, fillers, Botox and mid-face implants offer you a better option – good results and with less risk. But who knows? A year from now we may have something even better to offer you!
I love to help my patients get the look they want in the best way possible.
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