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Midface Lifting

The Midface

One of the areas that Dr. Zoumalan carefully evaluates in patients that seek cosmetic or reconstructive eyelid surgery is the midface area. The midface is defined as the middle area of the face, which is located between the lower eyelid and upper lip. The descent of midfacial structures can occur with aging, trauma, facial paralysis (Bell’s Palsy), or even prior surgery. Descent of the structures can occur through either loss of volume in that area and/or laxity of tissues. When the midface is addressed, Dr. Zoumalan attempts to either resuspend the midface to a “more anatomically appropriate” position or “fill” the area that is now depleted with volume to restore the appearance it once had.

Whether you are visiting Dr. Zoumalan for a cosmetic eyelid surgery or a reconstructive eyelid surgery, the midface will be carefully examined for any descent of structures, whether it is due to problems with volume or laxity. In cases where the midface needs to be addressed, Dr. Zoumalan will discuss all of your options with you. One involves a surgical procedure (midface lift) and the other can be done non-invasively through the use of fillers (i.e. hyaluronic injections and/or fat injections). Dr. Zoumalan will examine you and make the recommendation that best fits your needs.
Procedure performed: Endoscopic brow lift, upper and lower lid blepharoplasty with fat repositioning, lower lid chemical peel, fat grafting to midface and cheeks
Procedure performed: Lower lid retraction using a hard palate graft, canthoplasty, and midface lift

What are the different types of midface lifting?

Surgical Midface Lift:

The surgical midface lift procedure is usually done in combination with lower eyelid surgery. Dr. Zoumalan usually uses the incisions used for lower eyelid surgery to access the midface components and safely and effectively resuspend them to a higher, or more anatomically appropriate, position. The downtime is usually no more than a typical lower eyelid surgery, but the midface area can be swollen for several weeks. The incisions are usually hidden inside the eyelid and the skin incisions that are made are typically concealed in natural wrinkles. Dr. Zoumalan specializes in Oculoplastic surgery that addresses issues concerning the eyelid and surrounding structures, including the midface area.
Lower lid retraction using a hard palate graft, canthoplasty, and midface lift - female Patient before and after picture

Preoperative Diagnosis: Lower lid retraction.

Procedure performed: Lower lid retraction using a hard palate graft, canthoplasty, and midface lift.


*Individual results may vary

All before and after pictures displayed are real patients who have consented to having their pictures published on our site. Individual results will vary with each patient and Dr. Christopher Zoumalan does not guarantee any outcomes of procedures shown. All pictures are meant for reference and illustrative purposes only.

Non-surgical Midface Lift:

Volume augmentation is a non-surgical option for certain patients that may not require surgery. This is often the case in patients with mild midface descent or ones who may not require lower eyelid surgery. Various products can be used; Dr. Zoumalan will sit down with you to go over your options. Hyaluronic acids are quite effective, although the results are not long lasting. The advantage, though, is that this procedure can be done safely in the office, usually under topical anesthesia only. Dr. Zoumalan uses a cannula to inject his fillers in the office rather than a needle, which helps to reduce the rate of bruising, increases patient comfort and results, and is much safer in his opinion. Fat grafting can be an excellent option for some patients; fat grafting can often last for several years, if done appropriately.

Both produce desirable results, but appropriate patient selection must be performed. Dr. Zoumalan often employs surgical midface lifting (SOOF lifting) in cases of revisional eyelid surgery, where the elevation of the midface allows for a better contour and appearance to already surgically operated eyelids. Midface lifting can also help in reposition the midface in those that have had a prior facial nerve paralysis.

In cosmetic cases where patients have volume loss in the midface, Dr. Zoumalan often recommends volume augmentation. The downtime is quicker than traditional midface lifting surgery and patients can expect a natural-looking result. Hyaluronic acid fillers or fat grafting can be used to augment the midface. This can be done at the same time as eyelid surgery or by itself in the office.

Dr. Christopher Zoumalan is a board-certified oculoplastic surgeon in Beverly Hills, specializing in aesthetic and reconstructive oculoplastic surgery. Dr. Zoumalan is passionate about helping patients reach their ideal aesthetic and restore functionality with the leading cosmetic eyelid surgery, reconstructive eyelid surgery, and non-surgical cosmetic procedures. Dr. Zoumalan has been featured on several television shows and has traveled the world as a trusted oculoplastic specialist. Browse the video gallery below to learn more about oculoplastic procedures and treatments.
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