Q: Dr. Eppley, I am a 29 year old female and I am interested in a midface lift in hopes of achieving a cat eye look. I love how my hair looks when pulled back into a tight high pony tail. It gives me Asian eyes and lifts my cheeks.
I notice celebrities are having this look, people refer as the PILLOW… I read they have a lot of fillers and botox but i want something that will last longer.
I once had a temple lift with Endotine and done by endoscopic. I loved the results. It gave me exactly what I wanted…slanted eyes and my cheeks raised. But unfortunately it lasted no more than a month. My skin, just went back to it’s pre-surgery state.
So will a midface lift help achieve this for me? I see other questions you answered involving lateral canthoplasty, would that help as well? Which is preferred? Thank you so much for your time Dr. Eppley!
A: What you have learned from your midface lifting experience is that simply pulling on the skin up and back, like a tight ponytail, is not going to create a sustained result. It simply is not that easy. Such endoscopic temporal lifts alone always fail because skin pulling/shifting alone is not the answer for raising the corner of the eye and keeping the cheek tissue lifted. A direct approach to the corner of the eye (lateral canthopexy vs canthoplasty) is needed in conjunction with a high placed cheek implant and and an excisional temporal lift. Like a strair step approach, lifting and support needs to be added at three levels to get a better and more sustained result.
Dr. Barry Eppley
Q: Dr. Eppley, I would like to get a new shape to my eye that is more narrow and uplifted. I have attached a picture of the kind of eye look that I would like. I was able to create that look by using elastic bands attached to tapes as was seen in a video on Youtube to create an instant ‘facelift’.
A: Thank you for sending your pictures. What you are illustrating I would consider an extreme lateral eye reshaping result which I am not sure can come completely from a lateral canthoplasty alone. I know you were using tapes that pulled the corner of the eye AND the skin around it so it made a very artificial and not surgically achieveable look without pulling the temporal skin back with it. That issue aside it does illustrate that a subtle change in the corner of the eye will not be enough for you. The entire lateral canthal tendon will have to be shortened and pulled way back onto (through) the lateral orbital bone to create that much change. While that is possible it is likely to create a skin fold at the corner of the eye that can only be eliminated by combining that with a temporal lift.
Dr. Barry Eppley
Q: Dr. Eppley, The Lifestyle Lift (lower 2/3 of face only) left me with bunching/folding of skin at the sides of my face next to my eyes when I smile, which looks very unnatural. They are now recommending a forehead or temporal lift to try to correct this problem at my expense. Do you think this would be effective? I am looking for other opinions as I don’t want to waste my money. Thanks!
A: There are no other options for this problem. Although I would not make this effort until you are at least six months after the lift procedure to give it plenty of time to settle and relax if possible. This can occur as a direct result of this ‘cookie cutter’ type of facelift where all of the pull is vertical in front of the ear, creating bunching or ‘excess skin to the side of the eye and in the temple region. This is avoided by having the anterior vertical scar go well into the temporal hairline or out along the temporal hairline The excess skin created by the facelifting pull has to go somewhere and be redistributed. But if the incisional pattern is too limited, all it can do is bunch up at the point of the end of the skin excision. Not everyone’s facial aging problem benefits by a direct vertical lift, many need a more superolateral directional lift with a resultant longer scar on the back of the ear.
Your best treatment would be some form of a temporal lift. But that must be carefully designed to get an effective result.
Dr. Barry Eppley