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Endoscopic mid-facelift surgery

The four major mid-face aging issues: (1) under-eye bags/ tear trough (2) plump cheeks hollowness (3) deepened nasolabial folds, (4) sagging cheeks/mouth corners. When the mid-face is aging, there will be issues such as deepened nasolabial folds, eyelid hollowness and sagging mouth corners, and S-curve at the face in profile will also disappear naturally. This is often due to natural aging and the pull down effect of gravity, making the cheek tissues unable to support the cheeks and face lost its 3-dimensional feels, and the entire face became haggard, which is the result of sagging and looseness. Through the mid-facelift surgery, you can flatten the nasolabial folds and the loose skin on the lower edge of the cheeks. It is the so-called plump muscle, lift cheeks and remove the tear trough/under-eye bags, which are the goal of mid-face rejuvenation surgery.

The perfect "Ogee Curve" or "Profile in face S-Curve" of perfect mid-face refer to looking at young lady from the side at a 45-degree angle, descending from the lower eyelid to the cheekbones, there are two chubby curves above and under her plump cheeks: In addition to improving the position and shape of the eyebrows, the upper-facelift surgery, when performed by an experienced surgeon, can use the proportion of facial features more perfect and restore the youthful look. Along the cheeks to the chin another slightly concave curve is sketched out. These together form a perfect "S-curve or Ogee line."

The mid and lower facelifts are more complicated than the forehead facelift, mainly because there are complex blood vessels and nerves in mid-face and neck. Therefore, the surgeon must be very careful when performing the mid-facelift surgeries. The surgeons for facelift surgeries must receive special training and practices to perform them perfectly.

According to the classification by surgical contents s, what kind of mid-facelift are available out there?

  1. Endoscopic + Endotine-Midface mid-facelift surgery
    It is a technology that uses the endoscope to enter the patient's body through the incisions on pars temporalis hair and inside the mouth to combine the forehead facelift and mid-facelit. It adopts the most popular "Endotine-Midface" to perform the endoscopic cheek-lift surgery, and it is currently considered one of the best methods to resolve nasolabial folds and sagging facial skins. The biggest difference between this and the traditional method is that the traditional facelift opens an incision close to 15cm long from the cheeks to the back of the ears, and then it open up the facial skin, tighten the SMA fascia, and remove the excess parts before stitching up.
  2. Endoscope + multi-layer loop suspending suture mid-facelift surgery
    Its surgical procedure is similar that of the Endoscopic + Endotine-Midface mid-facelift surgery, but it uses a special suture for suspension at the end.
  3. Concentric malar lift
  4. 經下眼臉五爪勾中臉拉皮手術

    Compared with the Endotine-Midface facelift, the advantages of Concentric malar lift surgery are as follows:
    1. It provides better lifting to the skin and the subcutaneous fat.
    2. It provides more lifting and fix the parts onto the bone, so the effect is more stable
    3. It can firmly fix the lower eyelids, so the patient is unlikely to have eyelid ectropion issues.
    4. Fat shift can be performed at the same time to improve the face atrophy issue.
    5. When coupled with special equipment and materials, the surgery can be completed with the closed incision method to avoid external scars.

[Endoscopic mid-facelift] teaching video

Endoscopic mid-facelift [Purposes]

  1. It mainly treats the nasolabial folds caused by sagging cheek fat.
  2. Correct the sagging and hollow plump cheeks
  3. Remove the under-eye bags and tear trough (coupled with under-eye bag surgery the effect will be even better)
  4. Correct the sagging mouth corners
  5. Reshape the mid-face Ogee line

Endoscopic mid-facelift [applicable scope]

Mid-face aging and hollowness, deepened nasolabial folds, eyelid hollowness, sagging mouth corner and hollow plump cheeks

Endoscopic mid-facelift [Advantages]

  1. Reduce bleeding, small incision, less swelling, faster recovery
  2. Natural facial expression and fewer side effects after surgery
  3. No scars after the surgery and more satisfactory beauty effects


Precautions for one week prior to the surgery

  1. No smoking prior to the surgery because smoking causes vascular contraction and reduce blood supply to the skin and thereby affecting the healing of the incisions.
  2. Eat more fruits and vegetables to absorb cellulose and vitamin C, which can increase the ability of wound healing.
  3. Limit the intake of vitamin E to under 200 mg per day to reduce postoperative bleeding issues.
  4. Stop taking Aspirin and painkillers which contain Ibuprofen to avoid the postoperative bleeding issues.
  5. Control blood pressure and blood sugar: The operation must be performed under the condition of good and stable blood pressure and blood sugar.

The day before the surgery

  1. The nurse of our clinic will call you to re-confirm the operation time.
  2. Start fasting (including water) 6-8 hours before the surgery.
  3. Wash your hair the night before. Do not apply any hair spray or hair care products.

On the day of surgery

  1. You may bring your own hat or scarf.
  2. Do not carry valuable items such as rings or necklaces.
  3. Please arrive at our clinic at least half an hour before the scheduled time of surgery.

Postoperative instructions

  1. The patient needs to be accompanied by someone within 8 hours after the surgery and note any changes of consciousness.
  2. Drainage tubes will be used after the surgery to accelerate the deswelling. Therefore, the patient needs to return to our clinic the next day to change wound dressing and remove the drainage tube.
  3. 請勿自行脫下彈性繃帶,若有不適,或是傷口敷料滲出血水,請與本診所聯繫。
  4. Apply ice pack within 48 hours after the surgery. Beware of frostbite. Apply it for 20 minutes each hour and rest for 40 minutes. Do not over-do it. Apply hot packing after 48 hours. Beware of the temperature of hot packing (test the temperature first with the back of your hands) to avoid burns. Apply hot packing four times a day for 40 minutes each time.
  5. Always take medication on time. Take medication four times a day – after each meal and before going to bed. (If it hurts badly, take painkillers every two hours at most.)
  6. Wound care: Clean the wounds every day and night with a cotton swab moistened with saline and then apply ointment.
  7. Avoid irritating foods such as cigarettes, tea, coffee or chili peppers within a week. Also avoid seafood as much as possible to prevent allergies caused by stale seafood.
  8. When lying down, try to keep the head higher than the heart after the surgery to avoid bleeding and swelling caused by movement such as bending and bowing. Please also pad the pillow high.
  9. Make return visit to our clinic one week after the surgery to remove stitches and check on the wounds and recovery.
  10. Make a return visit to the clinic one month after the surgery for postoperative follow-up.

Dr. Yi-Sheng Kao Director | Plastic Surgery Aesthetic Clinic

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