Mid-face lift

The procedure

A mid-face lift aims to rejuvenate the area from the lower eyelid down to the folds that go from the corner of the nose down the side of the mouth (nasolabial folds). It lifts this whole area to restore a more youthful face, cheek and lower lid. It is performed whilst you are asleep either as an isolated procedure or in combination with other facial rejuvenation procedures.

What does it involve?

An incision is made just below the eyelashes of the lower eyelid, to ensure that the resultant scar is very discrete. The surgery releases the mid-face at a level just on top of the bone to free it up from its tetherings. Once mobilised, the mid-face it securely stitched internally to a higher position (one that it would have occupied in youth). Excess lower eyelid skin can then be trimmed, any bulging lower eyelid fat can be dealt with and the skin is the stitched with fine stitches.

What are the benefits?

A mid-face lift rejuvenates the middle of the face, softens any heaviness and sagging that has developed at the nasolabial fold and also improves the appearance of the lower eyelid area.

How long does the surgery take?

The surgery takes around 3 hours.

What is the recovery period?

You will have some swelling and bruising afterwards, which will fade after around 2-weeks following surgery. The scars themselves heal quickly. The stitches are removed at 5-7 days. If you have also had upper eyelid surgery, Mr Pacifico often puts a temporary dissolvable stitch in to prevent your eyes from opening too much and to ensure they are well-lubricated with tears. This comes out at 2-5 days. Your eyes may feel dry and gritty initially, but this usually resolves after a short time. Therefore lubricating ointment will be prescribed and should be used liberally.

How long before daily activities may be resumed?

Rest is advised initially, and it is recommended that you sleep with 2 or 3 pillows so your head is elevated - this will help the swelling resolve. Most people are ready to go out and return to work after 2-weels or so. Strenuous activity should be avoided for at least 4-weeks. Contact lenses should be avoided for 3 weeks after surgery, as these will dry the eyes out. Reading, television and computer usage may also dry out the eyes, so should be kept to a minimum.

What are the success rates?

Mid-face lift surgery has a high success rate. Potential complications are outlined below. Problems with dragging down of the lower lid is a possibility which is why Mr Pacifico will also perform a canthopexy as part of the procedure. This is an internal stitch at the outside corner of the eye that helps support the eyelid in its new position. Initially it will slightly pull the eye outwards and upwards, but this settles down after a week or so. You will look your best at 6-12 months after the surgery.

What are the possible complications?

You should expect some temporary numbness to the cheek and upper lip after surgery that will gradually improve as the swelling resolves. Permanent nerve injury is rare.

Small amounts of bleeding may occur after the operation - usually this settles with light pressure on the eyelid and cooling packs. Rarely, it may be necessary to return to the operating theatre to stop any bleeding. The most serious, but fortunately extremely rare, complication relates to bleeding that occurs behind the eyeball. This is a surgical emergency, which would require medicine and an urgent return to the operating theatre - if not attended to as an emergency, it may rarely lead to blindness (the risk of this complication has fortunately been estimated to be as rare as 1 in 40,000).

Scars can occasionally take time to settle down and may benefit from regular massage post-operatively, something Mr Pacifico will discuss with you at your post-operative visit. Infection occurs infrequently, as do small whiteheads around the scar, which may be treated in the outpatient clinic.  Inflammation of the eye can occasionally occur, which may need treatment with drops or ointments. Rarely, a muscle that moves the eyeball may be bruised or damaged leading to double vision (this rare complication usually only causes temporary symptoms).