Endoscopic Cranial Cheeklift

Q: Dr. Eppley, For an endoscopic cranial cheeklift , is it possible to lift the cheeks vertically without an eyelid incision? My eyelid skin is quite thin and ideally I would not like them cut. How long is the cranial/temporal incision?

2) How many times have you performed this surgery on young individuals in the same situation? I’ve been consulting surgeons who have rejected me for any sort of resuspension or lifting due to my young age and have just been pointed to fillers, which is quite upsetting. 

3) Are the sutures used in this surgery permanent or can dissolving sutures be used? Are they palpable in any way? I know endotine cheek lifts are an option but I do not think that work as well and am scared of the palpability due to my thin skin.

4) You’ve mentioned that two weeks would be the maximal recovery for swelling. I am planning to have this surgery done during my break which is just over a month and a couple weeks, but I would have limited time in Indiana as I am a non-American. Would it be possible for me to have the cheek resuspension surgery, wait out two weeks for majority of the swelling to dissolve, and then undergo a chin osteotomy procedure with my zygoma reduction surgeon back in my home country after the two weeks?

I understand it would be a lot of protracted swelling but is there any reason I cannot.

A: In answer to your endoscopic cranial cheeklift questions:

1) It is usually best to have a small incision at the eyelid so the subperiosteal dissection can be thoroughly completed and connect the tunnel between the skull and the intraoral incision for full cheek mobilization.

2) Most of these cranial suspended cheek lifts have been done on older patients. I have done only a handful on younger patients who have either had cheek implants removed or have had cheekbone reduction surgery.

3) The suspension sutures used are dissolvable.

4) I see no reason you can not have a chin osteotomy done two weeks after the procedure.

Dr. Barry Eppley
Indianapolis, Indiana