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Spa Services Procedures and Treatments » Mid-cheek Lift (endoscopic)

Mid-Face Lift (endoscopic)

The plump cheeks of babies provide a clue to how the aging process affects adult faces.  One of the first signs of facial aging often appears in cheeks that become less prominent and begin to look gaunt.  As the cheeks lose their roundness, we begin to see deepening lines from the edges of the nose to the mouth (nasolabial fold).  That’s because the cheeks take a double hit from the aging process.  First, they lose fat in the malar fat pads that lie under the cheek’s skin.  At the same time, cheek muscles begin to sag, causing the fat pads to drop from their original position over the cheek bones.  This combination creates a more hollowed and drawn look, with a deepening nasolabial fold.  The downward motion hollows the area below the eyes, pushes down the corners of the mouth, and causes the lips to narrow. 

Mid-face lifts, also commonly known as "mini lifts", address this issue and are especially beneficial to patients in their late 30s and 40s who are experiencing the first noticeable signs of aging but are not ready for a full face and neck lift.  The midface lift is a minimally invasive procedure that raises the cheek muscles and repositions the malar fat pads back to their original position over the cheek bones to recreate a more youthful contour.  To address the issue of diminishing fat, Dr. Sykes often transfers fat from the patient’s hip area to cheeks.  In addition, patients very often choose to have a forehead and brow lift at the same time to rejuvenate the upper two-thirds of the face.  Since both forehead and midface lifts are performed using small scopes fitted with cameras (endoscopic surgery) and can be done through the same incisions, combining the procedures enables patients to achieve a significant change with a single surgery and recovery period. 

What to expect
A midface lift is a minimally invasive procedure that requires a single incision about an inch long.  Through the small incision, the doctor inserts the tiny camera probe, enabling him to see the internal cheek structure without opening up the area.  The surgeon then tightens the cheek muscle, affixing it to the facial structure with long-lasting sutures that secure the muscle in its higher position.  They then lift the malar fat pad and secure it as well.  The entire procedure takes one to one and a half hours and is performed under sedation in an outpatient surgery suite.  When combined with other procedures, most commonly a forehead lift and fat transfer, the surgery will take longer and may be performed under a general anesthesia. 

The doctor places a protective dressing over the incision for the first 24 hours, which is removed during your post-operative visit the following day.  During the visit, your doctor will make sure the healing process is progressing as it should and answer any questions.  Your next visit will be a week later, when the doctor will again check your progress and remove your sutures. 

The minimally invasive technique Dr. Sykes uses allows patients to resume normal activities in about a week.  Pain is typically minimal and passes within the first two to three days.  Swelling and bruising will occur, but can be minimized by icing with frozen peas for the first 24 to 48 hours and keeping your head elevated for the first several days. 

Typical results
Depending on your age and the extent of aging in your cheeks prior to the midface lift, you are likely to see a subtle, but noticeably more youthful appearance with fuller cheeks and less noticeable nasolabial folds.  If combined with a forehead and brow lift or other procedures, the change will appear more dramatic.  The higher position of your cheeks will turn back time, creating a more youthful appearance.  The aging process will continue, but you will always look younger than you would have if you had not had the midface lift.   

Midface Lift Fast Facts
The following are general guidelines only.  Variations are common.

Surgery length:

1 to 2 hours


Office or hospital outpatient surgery suite


Light sedation or anesthesia, patient is asleep during surgery


External dressings wrapping the side of head to protect incisions removed the following day

Pain & discomfort:

Some pain for the first few days, most often dull and generalized.  Tightness in the cheeks.    

Swelling & bruising:

Moderate, generally peaking by day three.  Bruising typically fades in about seven days.  Most of the swelling resolves in the first week, though some residual swelling will remain for several weeks.  

Suture removal:

Typically at one week

Return to work:

One week

Resume exercise:

Four weeks

Initial results:

One week following surgery, when sutures are removed 

Final results:  

Six months


Permanent, affected by ongoing aging


Jonathan M. Sykes, MD
Professor/Director of Facial Plastic and Reconstructive Surgery
UCDavis Medical Group
2521 Stockton Blvd., Suite 6206
Sacramento, CA 95817
(916) 734-2347
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