With aging, cheeks and mid face drop downward and inward, which can cause a furrow to appear next to the nose and a hollowing effect over the top of the cheek.
Now, cheek mid-face surgery can be accomplished through the same lower eyelid approach that is used to remove excessive skin and fat in the lower lid. In fact, the two procedures can be done at the same time. Usually this is done through an incision on the inside of the lower lid and a small skin incision in the outer corner of the eyelid.
Dr. Putterman is one of the first surgeons in the Chicago area to perform this mid-face lift procedure (also referred to as "soof lift").
During the procedure, the tissues that line the cheekbones are released, from the lower lids to the upper lips and to the sides of the nose. This allows the cheeks to be pulled up and secured with internal sutures.
The procedure not only restores the cheek to a more normal position, it also smoothes out the fold that occurs on the side of the nose and decreases the hollowing at the top of the cheek.
If this operation is performed, it is necessary to horizontally tighten the lower eyelids by removing a section of the outer lids and then suspending what is left to the bony area of the outer lids.
Before and After Photos
Before Photo
After Photo
Click any photo above to enlarge
Cheek Mid-Face Lift Surgical Techniques
A. With age, the cheek fat which is normally in the upper grey area shifts downward and inward to the abnormal white position.
B. The cheek and mid-face is lifted through an eyelid incision. (This incision can be made from the outside of the lid as depicted here, or most commonly Dr. Putterman will approach it through an inside eyelid approach as demonstrated in the section on removal of excessive skin and fat from the lower eyelids A through C). The outer corner incision is always made.
C. Once the lower eyelid fat is removed or repositioned, an incision is made over the upper cheekbone.
D. The tissue that lines the cheekbone is released.
E. The diagonal lines indicate the area of the release of tissue from the cheekbone.
F. A full thickness section of the outer lower eyelid is removed and united together to stabilize the eyelid.
G. The cheek fat is connected into the more normal superior temporal position. The bottom outlined fat shows the abnormal position that occurs with age, and the upper shows the fat being returned to its normal position.
H. A triangle of skin and muscle is removed from the outer corner of the eyelid.
I. The skin is connected together.
Illustrations are from Dr. Putterman's textbook "Cosmetic Oculoplastic Surgery".
