ENDOSCOPIC MIDFACE LIFT
The midface is the middle portion of the face, and corresponds to the mid to upper cheek area just below the lower eyelid. Aging of the midface makes a person look tired and haggard because it creates a diagonal groove (known as the malar groove) that runs downwards and outwards from the lower eyelid to the side of the cheek. In addition, the most prominent part of the cheek bone tends to become flatter. These changes are a consequence of sagging of the cheek tissues.
Therefore, rejuvenation of the midface requires lifting of the cheek tissues back to their original position in youth where they abut against the lower eyelid area. This corrects the malar groove and restores fullness to the cheek bone prominence.
Dr Huang uses endoscopic techniques to perform a midface lift. This is performed through a scalp incision in the temple and avoids the need for incisions on the face.
A curved incision is made in the temple. The scalp in that area is elevated in a downward direction and over the arch and body of the cheek bone. The surgical dissection is completed from below through an intraoral incision on the inside of the upper cheek, which allows the soft tissues to be lifted off the lower part of the cheek bone.
The mid facial tissues are then lifted and stabilized using an endotine device that hooks the cheek tissues from underneath, lifts them upwards and suspends them to the muscle in the temple by securing the upper end of the endotine to the muscle with sutures. The endotine device dissolves and disappears six to twelve months later, by which time the lifted midface tissues will have stabilized. The temple wound is closed with skin staples and the internal cheek wound is closed with dissolving stitches. This technique avoids visible scars on the face, since they are hidden within the scalp of the temple and inside the mouth. The procedure takes about 3 hours and is usually completed under intravenous sedation as a day surgery procedure.
Postoperative pain is mild and well controlled with oral pain medication. There is a moderate degree of facial swelling, which may be accompanied by mild bruising. The face feels tight. The scalp staples are removed after ten to twelve days. It takes two to three weeks for enough swelling to subside and for some relaxation of the lifted tissues to occur, so that the face looks presentable. The downtime is therefore two to three weeks.
By about one month, the face is usually looking fairly natural. Exercise can be resumed at this time.
The results typically last for five to ten years.
Overall this is a safe technique as the plane of surgical dissection avoids branches of the facial nerve reliably. The risk of injuring this nerve is therefore very low. General surgical risks such as blood loss and infection are also very low.