Q: Dr. Eppley, I have read recently about a procedure that lifts up the cheeks using an implantable device. It is supposed to go away after it is implanted. This sounds appealing but I don’t understand how it works and what happens to it after it is put in. How can something create a permanent effect when it goes away? Since it is used and put in by plastic surgeons and is sold commercially, it obviously is legitimate but I am confused as to how it works. Can you explain it to me?
A: What you are specifically referring to is the Endotine Midface Lift Device. This is a small platform with small angled spikes on its outer surface that is made of a well known resorbable material known as poly-lactic acid. Many dissolveable sutures are made of the same material. The concept is that the sagging cheek tissues are lifted up back onto the cheek bones and are held there by this device. The device is attached to the bone and the small spikes face upward. The cheek tissues are lifted up on top of the device and are held in place by the angle of the small spikes. This repositions/resuspends sagging cheek tissues back up higher on the bone. The procedure is done through a small incision from inside the mouth. The device resorbs within a year after surgery and is replaced by scar tissue. In theory, the scar tissue then acts to hold the cheek tissues in place.
The nice thing about this device approach to a midface lift is that is fairly simple to perform and is done without scar from inside the mouth. Unlike a traditional midface lift, it does not disrupt the lower eyelid tissues and eliminates the risk of ectropion or lower eyelid sag. For the right patient if performed well, it can be a good midface lift operation. Understand, however, that no form of facelifting is permanent. As the device goes away and with time and aging, some cheek sagging will return.
Dr. Barry Eppley