What MIdface Lifting Technique Do I Need After Cheek Implant Removal?

Q: Dr. Eppley, I’m a fan of your blog articles – thanks for all the helpful information. I’m looking into getting a midface lift as I have sagging In that region from cheek implant removal. I would love to see someone who specializes here such as yourself, but am considering local options for consults to widen my net. One thing that has confused me, is one surgeon had recommended both temporal and oral incision while the other only temporal. When I enquired why (to both surgeons) they either did or didn’t incorporate the oral incision, the first said the oral incision has more nerve damage risk and can look more unnatural. The second said the oral incision is more effective in the area of the nasolabial folds and next to the nose and more of a purely vertical lift there. I’m a bit confused by the conflicting answers and would hugely appreciate any thoughts you had on this.

A: There are different techniques used in mid face lifting. One of the most common is the obliquely oriented temporal approach. The purpose of the intaoral incision in temporal-based mid face lifts is to maximize the mobility of the cheek soft tissues. This may be needed in some patients based on their history while in others it may not be. Because of your history of cheek implants removals you may either have good mobility of the cheeks soft tissues due to the presence of residual capsular tissues (and don’t need the intraoral incisions or, conversely, it may be more scarred down from capsular resorption and you may need to do so. This usually requires an intraoperative judgment to determine that need.

Certainly the intraoral incision is not avoided due to increased nerve damage or because the result may look unnatural.

Dr. Barry Eppley

World-Renowned Plastic Surgeon