As we age our mid face degrades, deflates and descends giving that dragged out tired look of ‘old age‘. The area between the lower eyelids and the mouth is considered the midface. As you age, the effects of gravity, repeated muscle contraction, and lifestyle cause the skin, fat, and muscle in this region to move downwards. When this occurs, the cheeks begin to look saggy or flat, lower eyelids can become puffy or hollow, circles begin to appear under the eyes, and the lines between the nose and the corner of the mouth deepen.
Midface suspension ribbon lift, also referred to as a cheek or midface lift, corrects sagging midface tissues by surgically repositioning them up and to the side. This accomplishes several goals: volume enhancement of the midface region, elimination of hollows in the area, and a gentle smoothing of the tissues just below the eyes. A successful midface suspension can be a key step in achieving the youthful appearance sought after in minimally invasive facial rejuvenation procedures.
Good candidates for mid face suspension ribbon lift are those patients who are starting to see some droopiness of the brow, cheeks, jowls and/or neck and would like to see a lift effect, but do not want the risk, scars, or recovery of a real browlift, facelift, or necklift operation. The ribbon lift procedure can achieve 60-70% of what a real invasive surgical procedure can deliver without the need for hospital care or general anesthesia. During a midface suspension procedure, the surgeon makes small incisions in the area above the ear, and in some cases through the mouth. Small instruments are introduced through the incisions to lift the delicate midface tissues off the cheek bones. A surgical ribbon implant is then passed through the cheek tissue and secured to the soft tissues above the ear. In some cases, the suspension ribbon is introduced through the skin and secured without elevating cheek tissue off the bones. In all cases, the surgeon relies upon the implant ribbon to temporarily fixate the suspended cheek in its new position. The ribbon is slowly absorbed and the tissues created by the body hold the tissues fixed in position.
Midface ribbon suspension restores the natural curves and fullness in the cheeks by moving soft tissues back to where they were earlier. This is achieved by elevating the soft midface tissue from the bone, repositioning it upward towards the eyes, and fixating it in place until it adheres naturally to the bone. This restores cheek volume and establishes more youthful midface contours. The result will be a natural, revitalized appearance that doesn’t appear overdone or “pulled.”
When performed skillfully, a midface ribbon lift will deliver a natural but noticeable improvement. It is frequently performed with other procedures. However, for many younger patients, under 45 years old, midface suspension is often a standalone procedure. Good candidates must have realistic expectations and be prepared to follow the postoperative recovery protocol and must be accepting of the risks. Poor candidates include those patients with unrealistic expectations, have uncontrolled medical illnesses that affect wound healing, are grossly overweight (with heavy faces) or are excessively thin, loose skin. The mid face ribbon suspension may be combined with other, more minor surgical procedures, such as fat transfer, Botox, Injectable Fillers, Thermalift, Thermage, Fractionated skin resurfacing, deep chemical peel or Fotofacial intense pulse light treatments. All procedures can be completed using local anesthesia by a cosmetic surgeon as in-office minimally invasive facial rejuvenation.