Cheeklift / Midface Lift
Cheek Lift Specialist
Dr. Barry Eppley is a sought after midface lift expert plastic surgeon who treats many facial aging patients with their sagging cheek concerns. His skill at helping his patients get a better and more refreshed facial look can be seen on his cheek augmentation results page.
MIDFACE/CHEEK SAGGING AS PART OF AGING
Aging affects all regions of the face from the forehead down to the neck. While facelifts improve the neck and jawline and browlifts improve the forehead, the central third of the face has fewer surgical options for aging improvement besides eyelid surgery. It is often neglected or overlooked in facial rejuvenation approaches. The cheek tissue is well known to descend downward with time and gravity, creating a roll of tissue below the cheek bones (malar descent) and making a significant contribution to the deepening of the nasolabial folds.
WEAK CHEEKBONES CONTRIBUTE TO MIDFACE AGING
Some patients are highly susceptible to developing sagging cheeks because they have a weak or underdeveloped bone structure. Their cheekbones are flatter and more recessed and do not provide much of a ‘ledge’ for which the cheek tissues can be supported. Thus, when the ligaments holding the skin and soft tissues to the bone weakens they are especially prone to drifting ‘south’.
DIFFERENT TYPES OF MIDFACE LIFTS/CHEEK LIFTS
The concept of a cheeklift is to reposition the fallen soft tissues back up onto the cheek bone. This can be done one of two ways, soft tissue resuspension or bone implant augmentation. In some cases, both cheeklift approaches may be used.
MIDFACE LIFT/CHEEK LIFT – SOFT TISSUE RESUSPENSION
A soft tissue cheeklift is done through a lower eyelid (blepharoplasty) incision where the fallen cheek tissues are lifted back up onto the bone. At the same time, a lower blepharoplasty is also performed which most facial aging patients need as well. A soft tissue resuspension midface lift may also be done through a temporal incision (temporal suspenion), a scalp incision (cranial suspension) or combined with the Endotine device to help hold up the cheek tissues. Almost every approach, however, uses a lower eyelid incision as part of the procedure.
MIDFACE LIFT/CHEEK LIFT – IMPLANT AUGMENTATION
A bony cheeklift is done by placing a specially designed cheek implant (submalar or combined submalar/malar shell) onto the bone through an incision inside the mouth. By adding bone support, the fallen cheek tissues are lifted up. The size of the submalar or shell implant will determine how effective this type of cheeklift is. For some patients this is all the midface lifting effect they will need.
Dr. Barry Eppley, performs other facial rejuvenation procedures, including neck contouring and browlifts. For rhinoplasty patients desiring a shapelier nose, he performs nasal surgery. And for patients who do not desire a surgical procedure, he offers Botox and a selection of injectable fillers such as Juvederm.
Cheeklift – Before Surgery
As part of an overall facial analysis for rejuvenation, the cheek tissues and the area around the eyes are evaluated. The strength of the cheekbones and the looseness of the cheek soft tissues are determined by physical examination and photographs. The decision for a soft tissue re-suspension or implant augmentation is then made. Either type of cheeklift is done is almost always done with other procedures such as a facelift, browlift or blepharoplasties.
The Cheeklift Operation
All cheek lifts are done under general anesthesia. A soft tissue re-suspension is done through a lower eyelid incision, often combined with an intraoral incision as well. This allows the cheek tissues to be completely freed up and lifted. The key to this type of cheeklift is in how to lift and maintain support to the bone as it heals. (where and how to the tissues) While many different methods have been described, my preferred approach is a cranial suspension technique where the sutures lifting the cheek tissues are passed under the temporal and forehead skin and sewn high up onto the skull bone directly above the outer corner of the eye. Malar shell or submalar cheek implants are introduced from inside the mouth and placed on top of the cheek bone. The implants are secured into position by a small titanium screw to the bone to prevent the risk of displacement.
Recovering from Cheek Lift Surgery
All sutures under the eyelid and inside the mouth are dissolvable so no suture removal is necessary. There will be some noticeable swelling around the eyes and cheeks but usually not much bruising. Expect the swelling around the eyes and cheeks to take 2 to 3 weeks to completely go away. Due to the lifted tissues around the eyes from soft tissue re-suspension one may initially have a tight or slightly overcorrected look that will take some time to look more natural. The risks of cheeklift surgery are infection (implants) and lower eyelid sagging (soft tissue re-suspension) that may require revisional surgery to correct.