Cheek Lift or Midface Lift

The midface region is defined as the area between the lower eyelids and the mouth. The midface is an essential element of an attractive face. Prominent, full cheeks give us a healthy, youthful appearance.

A deficient cheek structure can make one’s face appear drawn and gaunt. It can cause the lower facial features to look heavy and create a hollowness in the under eye area. As one ages, gravity, repeated facial expression, and loss of collagen, cause the tissue that once draped over the cheekbones to sag. When this occurs, the cheeks begin to look flat, the face appears gaunt, dark circles begin to appear under the eyes, and the creases between the nose and the corner of the mouth deepen.

Non Surgical Cheek Rejuvenation with Fillers

Fillers have become the new gold standard for cheek rejuvenation. While other modalities for cheek rejuvenation, like Midface Lifts, Cheek Implants, and Fat Injections are still used in some patients, fillers have by far become the most common and predictable way to augment the cheeks. Cheek fillers can be done in a few short minutes with minimal downtime and minimal risk. The predictability and customization that can be had with fillers for the midface and cheeks are unsurpassed by any other treatment option.

Endotine Midface Lift or Cheek Lift

The endotine midface lift or cheek lift is a surgical procedure that elevates the midface up towards the eye and out toward the temple. This repositions a saggy cheek back over the cheekbone by lifting the soft tissues upwards. This procedure is most suitable for a person who has always had a droopy looking cheek, even when they were young. An endotine is a small device with five tines or tissue graspers which gently and firmly elevate the tissue. These tines distribute the force on the tissues evenly, and can avoid dimpling or skin irregularities which can occur with conventional sutures.  This is performed through an incision inside the mouth and a small incision hidden within the hair in the temple area. The soft midface tissue is elevated from the bone, repositioning it upward towards the eyes and outwards. The endotine fixes it in place until it adheres naturally to the bone.  This elevates the cheek volume. Over the next one to two months, the tissue reattaches itself to the bone. The endotine begins to gradually absorb after it is placed.

A cheek lift or midface lift can be performed with other procedures to compound the rejuvenating effect. A full facelift improves the sagging tissues of the chin, neck and jowls, which are not addressed by a cheek lift or midface lift.  However,  for many younger patients under 45 years old, who have always had cheek volume that was too low, a midface lift is often all that is needed.

Cheek Implants or Cheek Augmentation

Some people are born with weak cheek bones. For those patients who would like a permanent solution, cheek implants can be used to augment the cheeks. Silicone cheek implants are usually placed high up on the natural cheek bone to simulate larger bones. This is done through a small incision inside the mouth. Cheek implant surgery or cheek augmentation is typically completed in about an hour. The drawback to cheek augmentation with cheek implants is that an implant addresses only the apex of the cheek bone, without addressing the zygoma, a feature of critical importance for proper facial balance. People who get cheek implants when young often need to balance out the face with fillers as they get older.

Dr. Aharonov prefers to place Cheek Implants through the mouth. This approach gives an excellent cosmetic result, without a visible scar. A small incision is made inside the Cheek within the mouth just above the gums. The Cheek tissues are carefully elevated until the covering of the Cheek Bone is identified. A small area or pocket, consistent with the shape of the chosen Cheek Implant, is created.  The Cheek Implant is then placed within this pocket of elevated tissue, and the facial tissues are closed with dissolvable sutures. This prevents the Cheek Implant from moving until the tissues are healed, and the Cheek Implant is secured in place. Initially, the cheeks, face or under eye area may be swollen or bruised, but this is highly variable from  patient to patient. As the swelling subsides, the Cheek Implants will begin to look and feel more natural. Some degree of numbness is to be expected after Cheek Implant surgery, but this too will subside with time. 

Fat Injections

Cheek augmentation can also be accomplished with fat injections. Depending on how your cheeks are, the main issue might be volume loss that is associated with aging. Augmenting your cheeks with your own fat is a way to restore your cheeks to how they used to be.

Fat is harvested from your thighs or abdomen and is specially treated to separate out the pure fat cells. This is then injected into areas of need in your face, which can include the cheeks, eyelids, jaw line, forehead, and temples.  The fat injections help reverse one of the biggest contributors to aging-- volume loss in the face. Facial volume loss leads to sagging brows, extra drooping skin on your eyelids, flattened cheeks, and a poorly defined jaw line. Fat injections can help reverse all these issues. Dr. Aharonov will discuss with you all of your options to come up with the plan that is best and most customized for you.

Preparing for a Cheek Lift or Midface Lift: Preoperative Information

All patients undergoing elective plastic surgery procedures should be in good health. Generally, you will see your primary care doctor for a physical exam and routine lab work. This is done several weeks prior to your Cheek Lift or Midface Lift. Please inform Dr. Aharonov of any existing medical conditions, medications, previous surgical procedures, or the use of alcohol, tobacco or drugs. Plastic surgical procedures are   best performed on patients that do not have any medical conditions that impair healing, and are nonsmokers.

It is very important to avoid taking aspirin and other non-steroidal anti-inflammatories such as Advil, Motrin or Aleve for one week prior to Cheek Lift or Midface Lift. These medications may cause abnormal bleeding during your cheek lift or an increase in bruising after your midface lift.  A list of over the counter medications and supplements to avoid will be given to you during your preoperative consultation.

It is also essential that you disclose any medical conditions such as under active or overactive thyroid, cardiovascular disease, high blood pressure, circulatory disorders, diabetes, blood clotting disorders, or a history of forming large scars also known as keloid scars.

It is also best to avoid alcohol and very salty foods for three days before Cheek Lift or Midface Lift to prevent your skin from retaining fluid and swelling. The night before your Midface Lift surgery, do not have anything to eat or drink after midnight in order to insure that you have an empty stomach prior to anesthesia. If needed, you may take your essential medications with a tiny sip of water in the early morning on the day of your Cheek Lift.

You should be in the most optimal nutritional state prior to surgery. An adequate diet with certain vitamin supplements such as Vitamin C is recommended. Dr. Aharonov can discuss nutritional supplements with you during your preoperative consult.

Anesthesia for a Midface Lift or Cheek Lift

Dr. Aharonov performs all of his surgeries in an AAAHC accredited outpatient surgery center in Beverly Hills. Board certified anesthesiologists, which are medical doctors, perform all of his cases. Dr. Aharonov prefers to have a physician caring for your anesthetic needs during surgery, as their experience minimizes the potential of unpleasant postoperative symptoms. For his surgical cases, Dr. Aharonov uses an extremely safe combination of iv sedation and local anesthetic, not general anesthesia. This technique provides superior operating conditions combined with maximal patient safety and comfort. In all likelihood, you will awaken with very little discomfort, nausea, or anesthetic side effects. In his Los Angeles area surgery center, all of the appropriate monitoring, medication and emergency equipment are available at all times. On the day of surgery, you will meet your anesthesiologist and can discuss any questions that you may have.

What to Expect After Endotine Midface Lift or Cheek Lift

After a Cheek Lift procedure in our Beverly Hills surgery center, there will be some swelling and bruising in the midface or cheek area, or even under the eyes or along the lower face. This can take several weeks to resolve, but individuals vary on their recovery time. Immediately post-op, you should use ice compresses to relieve the pain and swelling. You will be given a prescription for pain medicine and antibiotics, although most patients do not require much pain medicine after the first day or two. After one week, Dr. Aharonov will remove the sutures from your Cheek Lift in his Beverly Hills office.

You should avoid strenuous activities for a week after surgery to decrease any swelling. Most patients return to work in 10 days to two weeks. Occasionally, some patients report that they can feel the endotines when they touch their cheek area. The endotines will gradually disappear, and will not be noticeable after awhile.

Our Los Angeles area patients are extremely satisfied with the results of their cheek or midface lift. They have a more youthful appearance, without an unnatural pulled look.

Surgical Considerations for Endotine Cheek Lift or Midface Lift

Cheek Lift  or Midface Lift Preoperative Considerations

Anesthesia for Cheek Lift or Midface Lift

Postoperative Considerations for Midface or Cheek Lifts