The earliest signs of the aging process in the face area are manifested in the area called the middle face. The process starting in the lower part of the lower eyelids with dark color and collapse proceeds as the fat tissue that should be at the level of the cheekbone sliding over the laughing line. Mid-face lifting surgery is a process of removing the middle face soft tissue mass to a level just below the lower eyelid with 2-3 cm incisions made from the lower eyelid and temple area.
What does it mean to have a mid-face sag or loosen?
Practically you can see this problem in two ways:
1- An ejaculation at the bottom of the lower eyelids and appear darker
2- An increased fullness occurs on the laughing lines and the laughing lines deepen.
This problem is usually perceived as the deepening of laughter lines. In fact, the problem is not the deepening of the laughing line, but rather that the mid-face fat tissue that slides down on this line shows the laughing lines as deeper. If the skin and subcutaneous tissue on the cheekbone is pulled up with the fingertip in the majority of people with this problem, it is not only the laughing line that has improved but also the middle face due to the removal of the fat tissue.
What’s the difference between mid-face and face lifting?
The middle face is the process of lifting or stretching the front face region between the lower eyelid and the laughing line at the front of the face. The standard face lift surgery is the operation of the side region with the lower region where the face meets the neck. In this sense, both the stretched tissues are different regions and the directions of withdrawal or stretching are different. In addition, the incisions made to perform these procedures are in different places. In general, standard face lift surgery is more serious than a mid-face lifting operation.
Where are the incisions made for mid-face lifting surgery?
The cuts are made just below the eyelashes on the lower eyelid. The incision made from this leads to the fatty tissue of the mid-face area that has slipped downwards. However, as this can be seen during the removal of the skin and subcutaneous fat tissue at the tip of the finger, this process causes the tissues taken up to accumulate on the side of the eye. Therefore, in most cases, the temple region should be erected to prevent this accumulation.
A small number of cases or younger patients may not require additional treatment in the temple area because the skin is harder.
What can be said about the duration of surgery and postoperative period?
Mid-face lifting operations can be performed in three different ways.
-The first of these is the suspension techniques that have been applied for a long time and whose validity is very controversial. In this method, one or two sutures are placed on the middle face temple area with thick and permanent sutures extending from the temples to the fat tissue of the middle face. In some applications, in order to reduce the possibility of cutting the tissue and provide a deeper grip, the mouth is also added.
The most important problem of this technique is the reduction of the efficiency of the process due to the loosening of the stitch as it is in the other hanger techniques, and the deterioration of the symmetry.
In order to overcome these problems, special sewing materials have been developed which provide multi-point attachment in the form of fishbone. However, these stitches do not provide a permanent and natural-looking mid-face removal.
Either a natural invisible appearance appears to increase persistence, or the results appear good in the early period, but after a while, the tissue retention of the stitches decreases. The efficacy of the treatment is gradually reduced and lost as a result of cutting tissues.
The second method is the endoscopic operation by lifting the midface from below the periosteum.
Subperiosteal midface lift
First of all, this technique has not been so widespread in the postoperative period as expected due to edema and bruising. It is a highly aggressive and radical operation when compared to the size of the area to be removed. In addition, the removal of the middle face from the plan of periosteum did not provide a superficial lifting effect.
Today, effective on the midface, as little traumatic, less damaged and natural-looking operation in the middle-plan are lifting operations. Since this technique is close to the surface on one side, it provides an effective lifting effect and is not too superficial at the same time, it does not have pulling effect on the lower eyelid. Since the midface detection is in the area taken, it does not require an additional operation in the temple area. However, if there is excess skin at the eye edge as a result of the lifting of the middle face, temple stretching surgery will be required to provide a taut appearance. The main advantage of this method is that it provides an effective lifting, reliable permanence and a highly natural appearance. In the postoperative period, swelling and bruises disappear almost completely after 3 weeks. Although deep plan operations were performed on the technique of surgery, the long term results of deep plan operations were not found to be very successful. In addition, long-term edema is inevitable after such mid-face surgeries performed under the periosteum. Fatty and connective tissue, which is subject to change in the middle layer, can be determined in a permanent way by effectively uplifting. After this process, the healing process is about 3 weeks. Especially in cases where the temple stretching is done together, not only the middle face, but also the upper face region and forehead together are rejuvenated and the most striking areas of the face are permanently tense and attractive.
Is there a period of effectiveness of mid-face lifting?
Under normal circumstances, no process performed in the face area is required to be repeated in a lifetime. Mid-face surgery is an operation that should be performed once or alone with face lift. Contrary to popular belief, standard face lift surgery does not involve mid-stretching and does not alter the appearance of this area. Some techniques that have been applied for the last 20 years are aimed at providing an effective stretch on the face of the face lift operation. However, the mid-face problem, usually alone, is a problem in the younger patient group and can be performed without the need for standard face lifting.
Is making injection into midface an alternative to mid-face surgery?
The general process of aging in the middle of the face generally occurs in two ways. In a group, aging is mostly due to the decrease of subcutaneous adipose tissue.
In the other group, the skin and subcutaneous tissue may shift downwards without any loss of fat that may be defined as a heavy face. The practical distinction of these two can be separated by the maneuver of the skin from the eye edge. After this maneuver, the cases in which everything is in place are the cases where sagging is dominant. The patients in the other group were the patients who had desired appearance with filling Hyaluronic Acid to the under eye and laugh lines. Therefore, mid-face sag and mid-face emptying are biologically different processes. Filling with oil or hyaluronic acid is an accurate procedure for patients with moderate fat loss. The mid-face lifting operation applies to the mid-face of the middle face soft tissue shifting downwards. In order to avoid surgery on such faces, filling the emptied areas with hyaluronic acid or oil results in a heavier face that is both heavier and the center of gravity slipped down.
What are the risks of mid-face lifting?
-Torpor: There are only sensory nerves in the operation area that is operated during mid-face removal surgery. There may be temporary short-term drowsiness in the postoperative period.
Lower eyelid withdrawal: A more serious problem that may occur after these operations is withdrawal from the lower eyelid. If the received tissues are not correctly detected, they may form a withdrawal of the lower eyelids. Therefore, the mid-face lifting operation requires an accurate technique and experience.
Bleeding, Infection, etc.: As with all surgical procedures, there may be risks of bleeding infection, but these problems are not common problems in this group of patients.