article courtesy The youthful face is curvilinear with fullness in the upper midface, graceful curves, and a relative hollowness in the lower midface. The lower lid appears vertically short. With aging, there is an inevitable descent of cheek tissue which creates a depression hollowness of the lower lid area, emptiness of the upper face area, fullness in the lower face, and jowling. The lower lid sags and appears vertically taller. The neck skin and muscle loosen creating central fullness and blunting of the youthful, sharp distinction between the jaw and the neck.
The basic principle of the traditional facelift is tension. Tension in the midface is the enemy of the ?modern? facelift. Tension flattens the midface tissue which is unnatural and not youthful. Youthful faces, again, are curvilinear. The midface procedure restores the fullness of the upper midface, the hollowness of the lower midface and improves the appearance of the lower lid. The procedure is sculptural and tension-free, re-creating the soft and graceful curves of youth. The combination of the traditional facelift (for the neck) and the midface lift comprise the ?modern? facelift and constitute a powerful tool in facial rejuvenation.
The ?modern? facelift provides aesthetic advantages over a traditional facelift because it actually fills in the hollow areas by moving the soft tissue in a vertical direction, something not done by the traditional facelift. If the soft tissue volume of the upper midface is full relative to an empty lower midface and the silhouette of this contour relationship is flowing and graceful, the face will appear healthy, vibrant, and young. The best candidates are those patients considering a facelift and have concerns about the hollow appearance beneath their eyelids.
Some patients, usually younger, present initially with aging limited to the midface and lower lid area, without signs of aging in the neck. The midface lift procedure alone can correct this problem while avoiding incisions used in standard facelifts. Incisions are limited to two small areas in the mouth and two small areas in the hair above the forehead.
Ancillary procedures may be used to enhance results. Autologous fat grafting is a procedure where the patient own fat is transplanted from one area to another. About half of the fat survives long term. Lips are commonly augmented to replace fat lost with aging or to create a fuller, softer look. The drooping of the nose common with age can often easily be corrected with a ?peri-piriform? implant. The chin is often augmented to improve the jaw contour. Of course, a good skin care program is essential for the health and appearance of the skin.