An individual’s identity is often primarily determined by the face—its structure, overall appearance, and expressions. As such, age-related changes that can alter the appearance of the face may make an individual feel as if their identity has changed over time. Changes can occur in the upper, mid, and lower portions of the face; however, changes to the middle region of the face can often occur earlier than changes to the lower face. These changes may include loss of volume and sagging of the cheeks, as well as the development of deep wrinkles and hollow areas below the lower eyelids. Often appropriate for individuals who have not yet experienced sagging in the lower face, a mid facelift can help to reduce these signs of aging, restoring a firmer, more youthful appearance. This page describes the procedure for a mid facelift.
Before you understand how a facelift works, it is important to understand the underlying structure of the face and how the aging process causes it to change over time. The face is composed of layers of skin, muscle, and fat which lie above the facial bones. Much like a rubber band that has been over stretched, the tissues within your face weaken, losing their resiliency and ability to maintain a firm, youthful position.
Facial aging occurs for many reasons. In response to sun damage and other factors, your skin’s support network of collagen and elastin breaks down. As a result, your skin loses some of its structure and elasticity and becomes lax. Additionally, the facial muscles weaken and stretch, and fat deposits, which normally give the face a soft, rounded appearance, migrate downward and are depleted. In combination, these changes work together to create sagging cheeks, hollow areas, and deep wrinkles in the mid face.
How Does a Mid Facelift Work?
There are several different types of facelift—each specialized to treat different regions of the face. For example, the mid facelift is usually performed to rejuvenate the middle portion of the face. Age-related changes in the upper and lower region of the face are usually corrected with a forehead lift and lower facelift, respectively. In addition, sagging and puffy eyelids can be addressed with eyelid surgery. During a mid facelift, the underlying tissues are tightened, and fat pads that give the face shape and volume are shifted upward to restore a firmer, more youthful appearance. It is important to realize that a mid facelift cannot correct loose skin in the neck or along the jaw line, nor can it address fine lines or uneven skin tone and texture. Your physician will help you determine which procedure is best for you, and whether an additional procedure such as eyelid surgery or skin resurfacing would produce more global facial rejuvenation.
A mid facelift procedure may last approximately one and a half hours, depending on the extent of treatment. Prior to the start of your procedure, the treatment area will be cleansed and anesthesia will be administered. The procedure will most likely be performed under general anesthesia in which you are asleep.
Incisions in the Hairline
A mid facelift can be performed using a variety of different incisions and surgical techniques. For example, some physicians may choose to make incisions in the lower eyelid, among other locations. However, the endoscopic approach is gaining in popularity. With this approach, the physician generally makes small incisions just above the hairline. They may insert an endoscope into the incision, which is a thin, tube-like instrument used to see inside the body. In order to access the fat deposits that will be lifted during the procedure, the physician may use blunt forceps to elevate the underlying tissues. Working toward the mouth, they carefully lift the tissue creating a small tunnel in the mid-face.
Incisions in the Mouth
Using a retractor, the physician will expose the inside of the mouth and make two small incisions along the gum line. As before, using blunt forceps they carefully elevate the tissues in the lower portion of the mid-face to open the region between the upper and lower incisions.
Adjusting Positions of Fat Deposits
The physician will place what are known as suspension sutures in the fat deposits that have migrated downward with time. By threading the sutures through the incision in the hairline, the physician elevates the fat deposits and suspends them in a higher position. In doing so, the physician restores soft, round contours to the mid-face.
Once the physician has finished making the necessary adjustments to the underlying structures, they may choose to place a surgical drain beneath the skin to prevent fluid build up as you heal, although this is typically not necessary. The incisions in the hairline and the mouth will then be closed using sutures.
Mid Facelift Recovery
While some physicians prefer not to use bandages, others may apply a loose-fitting wrap or a compression garment to facilitate healing. A compression garment is tight-fitting, and will help to reduce swelling by preventing fluid build up, as well as provide comfort and support as you heal. Although loose bandages may be removed in several days, compression garments are often worn for a few weeks.
As with any surgical procedure, you will likely experience some pain, bruising, and swelling, most of which will subside within a few weeks. If a surgical drain was used, it will usually be removed within a day following surgery, and non-absorbable sutures may be removed in seven to ten days. You will feel well enough to return to work in one to two weeks; however, you should avoid strenuous activity such as heavy lifting or exercise for up to three weeks to allow your body sufficient time to heal.
Mid Facelift Results
You will typically start to notice the results very soon after your procedure. They will become even more evident in two to three weeks, as the bruising and swelling continue to fade. As all individuals heal at different rates, the final results may continue to evolve for several months. Although a mid facelift will not stop the aging process, it can significantly reduce the appearance of loose skin, deep wrinkles, and hollowness in the face, restoring a youthful appearance for many years to come.