Midcheek Lift by Dissecting through the Facial Soft Tissue Spaces

Abstract

Summary: The midcheek lift is one of the most effective procedures to rejuvenate the aging midface. However, it is a technically demanding procedure with the risk of complications, such as scleral show and ectropion. In 2015, the authors published their midcheek lift technique and outcomes. In this Video+ article, the authors present refinements and nuances of their surgical technique, emphasizing technical aspects of this procedure that have enabled them to perform the operation safely and effectively. The key concept of their approach is to minimize the trauma associated with surgical access, by dissection through the facial soft-tissue spaces that are the gliding planes of the midcheek. This minimizes postoperative bleeding and scarring, which are the main contributors to the dreaded postoperative contracture-related complications. To effectively mobilize the midcheek, precise sharp release of specific midcheek retaining ligaments separating these facial soft-tissue spaces is performed. Conservative skin excision is emphasized along with routine canthopexy for lower lid support.