Facial cosmetic surgery
Mid-facelift (cheekbones, dark circles under the eyes, folds)

The mid-facelift or centro-malar facelift aims to reposition the facial tissue located between the eyes and the mouth (midface) to their proper place

Over time, the tissues of the mid face literally droop. The result is a hollowing under the eyes, elongation of the lower eyelid with a tendency to create a round eye (disappearance of the almond shape), a loss of volume of the cheekbones, the formation of nasolabial folds and bitterness folds (“marionette lines”), and the appearance of puffy lumps on either side of the chin making the face appear square (cheeks).

 

lifting centro-facial

Principle of procedure

The surgeon makes an incision just below the eyelashes of the lower eyelid (sub-eyelid incision) identical to that used to remove excess skin in the lower eyelid. From that incision, all the soft tissues of the cheek are detached from the bone to be repositioned higher.

Invisible facial threads are attached through small perforations in the cheekbone (palpable bony arch under the eyes).

At the end of the procedure, excess skin of the lower eyelid is removed.

Associated procedures

All other methods of facial cosmetic surgery may be associated with a centro-facelift according to patient needs.

  • A liposuction of the neck and certain areas of the face is almost always associated.
  • It is also common to perform eyelid surgery at the same time with or without a temporal lift.
  • Re-injecting the previously removed fat from the face and neck or knees, helps restore volume to the cheeks, eyebrows, lips, chin and soften the nasolabial folds, hollow temples and cheeks.
  • Certain facial muscles can also be remodeled. In particular, the DepressorAnguli Ori muscle (DAO) can be cut through two 1 cm incisions located in the mouth, which allows the downward pull of the corners of the mouth to be removed. This particularly sad aspect of the mouth (folds of bitterness) is rarely considered by surgeons.
  • An upper lip lift also helps restore the mouth to its original expression.
  • A traditional facelift can be proposed in addition to the centro-facial lifting. This technique is performed either during thesame operation, or more frequently during a separate procedure.
  • A browlift (or forehead lift) helps to diminish the wrinkles of the forehead and replaces the eyebrow higher.

Non-surgical techniques are also often considered in addition to a mid-facelift :

  • Botulinum toxin injections or hyaluronic acid injections can be performed during surgery if the injection site is different from the surgery site. Otherwise, the injections are given 15 days before or after surgery.
  • Electro-rejuvenation (Timed) or dermabrasion are used to correct fine lines located at the upper lip.
  • A glycolic chemical peel (light superficial peel) or TCA trichloroacetic acid (medium peel) can be performed on the day of surgery and improves the complexion and radiance of the skin, removes pigmented marks and blemishes, and reduces fine lines.

 

The procedure is performed under general anesthesia.  The duration varies between 1 and and a half hours and 3 hours. 

Hospitalisation is 24 hours.

After discharge from the clinic no dressing is required. Applying ointment to the scars is sufficient.

Post-operative effects

There is almost no pain that is relieved by appropriate analgesics.  A feeling of pressure and tight skin is normal during the first couple of days. The after effects are characterized by edema (swelling) of the face and ecchymosis (bruises) of varying importance depending on the patient and disappear during the first 2 to 3 weeks.

It is necessary to wait 3 to 6 weeks for the results of the procedure to be unnoticeable.  Hardening and decreased sensitivity of the lifted sites or the upper lip may persist for 1 to several months.

Result

The result is natural. The face doesn’t appear to be either frozen or surgically enhanced. 

The facial features give a fresh, rested and relaxed look.  The scars are very discreet, sometimes pink for several weeks but are easily camouflage with makeup. They are unnoticeable after 3-6 months.

Risk of complications

As with any surgery, a number of complications can occur. But the likelihood of these complications is reduced in the hands of a qualified plastic surgeon and in the presence of a competent anesthetist. The patient’s compliance to instructions given by the surgeon is also essential and include :

  • stopping smoking 1 month before and after the procedure (reduction of all risks) ;
  • not taking aspirin for 10 days before and after the procedure (reduced risk of hematoma).

Fortunately, postoperative effects are generally manageable following a mid-face lift that has been carried out properly, so serious complications are rare.

In spite of the fact that complications are so rare you must be aware of the following problems :

- A hematoma : this can be drained without sequelae.

Infection : this is extremely rare when the procedure is carried out in sterile environment.

- Lower-eyelid retraction : massages usually solves the problem. Very rarely, another surgery is necessary.

- Nerve damage : the side effect usually disappears in a few months.

In case of a complications, your surgeon will treat them successfully if necessary.

In practice, the vast majority of cases take place without any problem and the patients are satisfied with the result.

Health insurance coverage

As this procedure is considered purely for aesthetic purposes, no coverage is provided by health insurance.

Author:
Specialist in aesthetic surgery - Antibes
Updated: 16-08-2015

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