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Out of all the people I've met that wanted facial
plastic surgery, there was not a single one that desired a 67% improvement
in his or her appearance. Two-thirds better? Of course, that sounds
ridiculous, but that's exactly what we've been doing for years!
In the past, cosmetic facial
surgery has concentrated on concerns of the forehead and eyelids
(the upper third of the face) with procedures such as browlifts
and eyelid lifts. Jowls
and turkey neck of the jaw and neckline (the lower third of the
face) were corrected with facelifts
and necklifts. But until
the mid face lift was developed recently, there had been no technique
to adequately address the multi-faceted changes that occur in the
middle of the face, leaving a tired and aged appearance despite
the best efforts to improve one's look.
To understand facial aging better, let's take a look
at the mid face. Over time, gravity, repeated muscle contraction,
and lifestyle choices cause skin, fat, and muscle to move downwards,
particularly in the area between the lower eyelids and the mouth
known as the mid-face. An improperly positioned mid-face can accentuate
the aging changes around the mouth and chin. Sagging of the cheeks
results in apparent puffiness of the lower eyelids, under eye circles,
an indentation in the upper cheek region, and a deepening of the
the line between the nose and the corner of the mouth.
With traditional facelift surgery, the tissues are
pulled to the side of the face through incisions made along the
hairline, and in front of and behind the ears. In contrast, the
mid face lift can be performed through incisions made only inside
the eyelid and provides the ability to elevate the cheek skin, fat,
and muscle vertically to compensate for gravity's downward pull.
Because of this, a mid face lift is sometimes referred to as a "vertical
lift" or "cheek lift".
While there are five or more approaches to the mid
face lift, my preferred method is through the inside of the eyelids
and sometimes the mouth thereby avoiding any external scars. One
has to be careful with this approach, however, not to create an
undersirable outcome such as pulling down of the lower eyelid, known
as eyelid retraction.
This procedure should, therefore, be perfomed only by an experienced
surgeon, competent in advanced lower eyelid and facial surgeries.
During the operation, the tissues are lifted and then
suspended to deeper structures to prevent early recurrence of cheek
descent. Regardless of technique, the ultimate goal of the mid face
lift is to restore the natural convexity and fullness of the lower
eyelids and cheeks, reposition cheek fat to its original position,
and provide fullness to the midface.Ultimately, this will produce
a natural and youthful appearance to the face without an overdone
or pulled look.
In addition to elective or cosmetic surgery, a mid
face lift is sometimes performed for facial
reconstruction. It can be used to repair eyelids that turn out
from birth defects, scarring, or previous cosmetic surgery. A mid
face lift can correct eyelid retraction from tumor, thyroid eye
disease, trauma, or nerve and muscle disorders. It is also used
to suspend a cheek that may have been weakened or paralyzed from
stroke or Bell's palsy.
A mid face lift can be done under local anesthesia
or IV anesthesia, and typically takes two to three hours. Some individuals
with less extreme sagging may need only a minor procedure of about
an hour's duration to reposition fat around the eye (called a SOOF
lift). A mid face lift is often combined with tear
trough or cheek implant insertion, fat
transfer surgery, eyelid
surgery, or with skin rejuvenating procedures such as a chemical
peel or laser resurfacing. A mid face lift will not address
skin wrinkling, an aging neck, upper eyelid concerns, or forehead
wrinkling and drooping.
Surprisingly, it took centuries or more of aesthetic
facial plastic surgery to realize that the middle third of the face
was being overlooked. Through careful analysis and understanding
of the specific direction in which the face ages, the mid face lift
originated and was further developed. Now that the mid
face lift is an option for facial enhancement, you can be sure
of the most natual, most complete rejuvenation to date.

Dr. Jonathan Hoenig provides the most advanced and innovative techniques
in facial plastic surgery and facial rejuvenation today. To learn
more about facial plastic and reconstructive surgery, visit us on
the web at http://www.la-plastic-surgery.com,
email info@drhoenig.com,
or phone toll free 866-HOENIG9.
dr. hoenig
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