What Is a Mid-Facelift and Who Is it Best For?

What Is a Mid-Facelift and Who Is it Best For? featured image
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Getting a facelift today is vastly different than it was 10 years ago. Though there have always been deviations from the full facelift, the mid-facelift has become even more popular as of late. This can be attributed to the increased demand for less-invasive and shorter-recovery procedures. The post-pandemic “Zoom Boom” also elicited a spike in treatments for cheek rejuvenation, which the mid-facelift achieves. Here, top facial plastic surgeons explain everything there is to know about the trending mid-facelift, including who it’s best for and what the recovery looks like.

What is a mid-facelift?

“A mid-facelift is a surgical procedure to that is designed to elevate the upper part of the cheek,” explains New York facial plastic surgeon Konstantin Vasyukevich, MD. “This type of a lift could be done in combination with other surgery, such as a deep-plane facelift.”

“The goal of a mid-facelift is to rejuvenate and lift the middle portion of the face,” says Beverly Hills, CA facial plastic surgeon Kimberly J. Lee, MD. “It targets the area between the lower eyelids and the mouth, including the cheeks. It also targets the nasolabial folds—the laugh lines that run from the nose to the corners of the mouth.

A mid-facelift can be performed in many different ways, so it’s best to consult with a few different plastic surgeons to find the best option for the results you’re looking for. Generally speaking, Dr. Lee says the surgery involves “repositioning the underlying facial tissues, including the fat pads and muscles. This restores volume, reduces sagging and creates a more youthful appearance.”

Who is a mid-facelift best for?

Dr. Lee says the procedure benefits those who have mild-to-moderate signs of aging, primarily in the middle portion of the face. “Ideal candidates have descended or flattened cheek fat pads that contribute to a tired or aged appearance, deep nasolabial folds, and a loss of volume in the cheeks or midface region. They also typically have relatively good skin elasticity and minimal signs of aging in the neck and jowl areas.”

According to New York facial plastic surgeon John Kang, MD, a mid-facelift is ideal for someone who looks great simply by drawing their hair back in a ponytail, thus often called ponytail lift. “In other words, if you look great by pulling your cheeks superiorly toward your temporal hairline area, you would be an ideal candidate. The greatest amount of pull will be in the upper face, followed by the lower cheek area. However because skin is contiguous, you can often see improvement of the jawline and neck as well. This depends on the patient’s anatomy and the technique used by the surgeon.”

“The mid-facelift is truly the hub to the whole aging process in the face. I have embraced this technique for the last 25 years,” Dr. Kang continues. “For me, this surgery truly reverses the aging process from the gravity effect.”

What is an endoscopic mid-facelift?

“An endoscopic mid-facelift is a surgery intended to elevate the upper part of the cheek,” says Dr. Vasyukevich. “Typically, an endoscope is used to assist with the surgery, hence the name endoscopic mid-facelift. This procedure also has a strong brow-lifting effect. The best candidate is someone who would benefit from both elevation of the brows and lifting of the upper cheeks.” You may also see a procedure called a “temporal endoscopic mid-facelift,” which Dr. Vasyukevich says is essentially the same thing. Tiny incisions are made in the temple area and hidden by the hairline.

When is a full facelift necessary?

A mid-facelift can result in improvement of the jawline and neck for some people. However, if the patient’s main concern is improving their jawline, jowling and neck, a full facelift is recommended. “A full facelift is typically best for those with more advanced signs of aging. These include significant skin laxity, deep wrinkles and folds, and jowls and/or neck sagging with loss of definition in the jawline. Also, excess skin or fat in the neck area,” Dr. Lee adds. “A full facelift is often combined with a necklift to address the entire face, including the midface, lower face and neck. This provides more significant lifting and rejuvenation. It’s always best to consult with a plastic surgeon for a personalized evaluation based on your unique anatomy, concerns and goals.” 

There is one very important caveat about the full facelift, Dr. Kang explains. “It takes the vector of the pull more laterally (backwards) toward the front and back of your ears. Depending on position of your ear and how wide and flat your bony features are, the classic jaw and neck pull around your ears can make you look awkwardly windswept in appearance. This is especially true if you are a patient of Asian descent.”

In these cases, Dr. Kang says patients would be better served with a more conservative but upwards vector that the mid-facelift provides to obtain a more natural look. “This helps avoid the dreaded windswept look that optically can make the face look flatter. Many surgeons, including myself, have incorporated a composite type of lift. We perform a full facelift to address both the more lateral pull that the classic jawline and necklift requires, along with the superiorly directed pull that the mid-facelift provides.”

What anesthesia is required for mid-facelift surgery?

“Both general and local anesthesia with a mild sedation can be used for this procedure,” says Dr. Vasyukevich. This is dependent on the type of mid-facelift being performed and the needs of the patient. “The surgery typically takes one-and-a-half to two hours to perform,” he adds.

What downtime should be expected after a mid-facelift?

“Expect to take a week or two off for recovery,” says Dr. Vasyukevich. “Bruising and swelling under the eyes is the most common visible sign of a recent mid-facelift. The pain is usually not as significant as with some other cosmetic surgical procedures; however, there’s a sensation of numbness and tightness in the postoperative period. Restrictions include limiting one’s physical activity, sleeping with the head slightly elevated, and keeping the bandages on as instructed by the surgeon.”

Remember that every patient is different, and some will bruise and swell more than others, regardless of the technique used. Additionally, patients should expect their doctor to provide detailed instructions and recommendations for optimal healing. This will include taking a break from strenuous activities and exercise. It will also be advised that patients sleep on their back for a week or more during recovery.

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