Mid facelift technique has two primary goals: correct the bulging of the lower eyelid fat, and elevate the drooping cheek fat pad, which in turn eliminates or softens the laugh lines (nasolabial folds).
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a series of Snapchat videos to explain his mid facelift technique—which is a combination of meticulous dissection and use of implants—that allows him to deliver natural-looking results that can persist long term.
Dr. Smiley said that a young face as an inverted triangle shape (from the lower eyelid down to the jawline); however, aging causes the skin to lose its elasticity and the fats to shrink. The descent and atrophy of the soft tissue leads to a straight-up triangle shape, a key variable that gives away the age of the face.
Hence, the goal of mid facelift technique is to reverse such effect, he explained.
The patient shown in the video required a short incision behind the hairline in the temple area. Dr. Smiley highlighted the importance of going deeper into the fascia and muscle, which he separated from the underlying bone.
“This is a very deep lift, which does not result in visible scar,” he explained. Going deeper into the structures, he suggested, leads to stable and natural-looking results, which are difficult to achieve with the antiquated facelift techniques in which only the skin is lifted.
After separating the soft tissue from the bone between the lower eyelid and cheek, Dr. Smiley created another incision he placed inside the mouth so he could pass a “specialized implant to do the lifting of the entire mid cheek.”
The implant, called Endotine, is an absorbable device with several hooks and spikes, meaning after a few weeks it is “totally absorbed by the body,” although not until it has created a strong adhesion to support the elevated position of the cheek fat pad, said Dr. Smiley.
To achieve a more balanced and rejuvenated appearance, the patient’s bulging orbital fat responsible for the appearance of hung-over bags was also repositioned and made closer to the lower lid during surgery.
Because the mid face is usually the first region of the face to experience aging, Dr. Smiley said that mid facelift generally suits “younger” patients between 40 and 55, while the standard technique favors 55 years and older with their more advanced soft tissue laxity.