The structures in the mid-facial area are the lower eyelids, cheeks, and cheekbones. With the age, the fullness of the cheeks decreases, the cheeks slide down, the mid-face area becomes flattened and flattened. The face loses its oval appearance and becomes rectangular. The bags on the lower eyelid become prominent and the lower eyelid appears to be elongated. A deep line is formed between the cheek and the eyelid. This line is called the tear trough. This image makes people look tired and old. In addition, the sagging cheeks cause two deep lines to form between the nose and lip edges. These lines are called nasal-lip grooves (nasolabial groove).
The purpose in the mid-facial area is to replace the soft tissue that has been lost, to move the sagging structures up and to correct the deteriorated lower eyelid-cheek relationship. The rejuvenation procedures that can be performed in this area include the lower eyelid surgery (lower blepharoplasty), endoscopic mid-facial lift, mid-facial lifting operations from the lower eyelid, mid-facial straps, fat injections, and fillings.
Frequently asked questions related to the mid-facial rejuvenation procedures:
Who is the mid-facial rejuvenation procedure for?
As the age progresses, the people having flattened mid-facial area, drooping cheeks, developed tear duct deformity, and deepened lip-nose grooves are the candidates for this type of surgery. Since such problems become more evident in the middle ages, such procedures can be performed on the people aged 35-50 who do not require the facial lifting, but whose problems are limited to the mid-facial area.
As the age progresses, the people having the flattened mid-facial area, drooping cheeks, developed tear duct deformity, and deepened lip-nose grooves are the candidates for this type of surgery. Since such problems become more evident in the middle ages, such procedures can be performed on the people aged 35-50 who do not require the facial lift, but whose problems are limited to the mid-facial area.
How are the mid-facial rejuvenation procedures done?
In the mid-facial region, the mid-facial hangers and filling processes are often applied together.
-The adipose injections are made to the mid-facial area in order to eliminate the soft tissue loss that occurs over time on the cheek. With the adipose injections, the tear duct deformity is corrected, the cheeks and cheekbones are clarified, the face is given an oval shape again, and the nose-lip grooves are filled. In addition to giving fullness, the adipose injections also increase the collagen synthesis by transforming the stem cells into the fibroblasts, by providing brightening and rejuvenation of the skin. It reduces the fine wrinkles, reduces under-eye bruises. In the young patients, the adipose injections alone can be sufficient without the mid-facial suspensions. The adipose injections are also a good option in the young patients having developmentally depressed midface.
-The purpose of the lower eyelid surgery (lower blepharoplasty) procedure is to remove the bags that have formed under the eyes, to transfer this adipose to the tear trough, and to correct the relationship between the cheek and the lower lid. Frequently, mid-facial straps and adipose injections are also performed.
-The mid-facial lifting procedures are either performed through an incision in the lower lid during the lower eyelid surgery or endoscopically with the help of a short incision made from the scalp. When it is done from the eyelid, it can be done under or over the bone membrane (periosteum).
-The endoscopic mid-facial lifting procedure is performed with the help of a camera inserted through a short cut in the scalp. The endoscopic forehead lifting is also usually performed during this surgery. If necessary, an additional incision is made through the mouth. It is a very effective method, but the swelling that lasts for a long time can make patients nervous in the first months.
-The silhouette hanger (Silhouette lifting): It is a suspension system developed for the purpose of suspending the mid-facial area of the silhouette lift without the surgery. The mid-facial area is moved up with the help of special threads sent to the face through a 1 cm incision made from the scalp. It is more suitable for the thin-skinned and middle-aged patients. It pulls the cheek up, reduces the lip-nose grooves, and reduces the clumps on the chin. It can be performed under the local anesthesia and in office conditions. If the adipose injections are made together with it, its effectiveness increases. Its effect lasts for several years. It does not cause the swelling and bruising. The patient can return to her daily life the next day.
What should be done and what should not be done before the surgery?
As it is in all surgeries, it is necessary to stop aspirin and smoking 3 weeks before the surgery in mid-facial rejuvenation procedures. In the last week, it is necessary to stay away from the drugs and similar substances that can dilute the blood.
Those not required to be used:
-The painkillers such as Apranax, Voltaren, Vermidon (Minoset, Novalgin can be used when pain relief is required),
-The multivitamin pills containing substances such as ginseng, ginko biloba, co-enzyme Q,
-Green tea, flaxseed, cherry stalk, tomato seed herbal products
-All weight loss products
Is the anesthesia required in the mid-facial rejuvenation surgeries?
The adipose injections, lower eyelid surgeries, endoscopic mid-facial lifting procedures are performed in the operating room environment, under the general anesthesia or heavy sedatives (sedation). The silhouette lifting can be performed in the office environment with the local anesthesia.
How long does the mid-facial rejuvenation surgery take?
The adipose injections take 45 minutes, silhouette lift takes 30 minutes, lower eyelid surgeries and endoscopic mid-facial lifts take 1-1.5 hours.

Are the mid-facial rejuvenation surgeries painful?
The silhouette lifting and adipose injections are painless. After the endoscopic mid-facial lifting procedures, the patients can feel tension and pain, but it can be easily controlled with the painkillers. The lower eyelid surgeries are also painless.
What happens after the mid-face rejuvenation surgery?
The silhouette lifting procedures are often performed in the office conditions and the patients can go home immediately. The bruising and swelling are not expected. The patient can eat and stand up 3 hours after the adipose injections, lower eyelid surgeries and mid-facial lifting procedures. Usually, the patient is discharged from the hospital after 6 hours. The patient can take a bath the next day. The stitches are removed after seven days. The long-lasting bruising and swelling occur after the adipose injections, lower lid surgeries and mid-facial lifting procedures. It can take up to three months for the swelling to completely go down, especially after the endoscopic mid-facial liftings. As after all facial surgeries, the patient is required to protect herself from the direct sun for 3 months after the facial rejuvenation procedures.
What kind of problems can be experienced after the mid-facial rejuvenation surgery?
The endoscopic mid-facial lifting surgery is an effective procedure, and its results are long-lasting. It is the long-lasting swelling that bothers the patients the most. Although rare, the problems such as asymmetries, lip paralysis, unnatural appearance in the face shape or insufficient effect can occur. The paralysis usually resolves within 2-3 weeks. The problems such as delayed recovery, conjunctival edema in the eye and pulling down on the lower lid can occur after the lower lid surgery. Such problems can be corrected over time or with the additional surgical interventions. The swelling and bruises occur after the adipose injections. The results of the injections made around the eyes and on the cheekbones are permanent. There can be some loss in the nose-lip lines. The effect of the silhouette hangers lasts for the several years.
Are the results of the mid-facial rejuvenation surgeries permanent?
The results of the endoscopic mid-facial lifting procedures are permanent. As the patient's age progresses, there is some sagging on the face, but it does not become old. The adipose injections give permanent results around the eyes and mid-face. The nose-lip lines need to be repeated frequently. However, in addition to its filling properties, the adipose injections make a permanent rejuvenation and refreshment of the facial skin by means of the stem cells it contains. The effect of the silhouette straps lasts for several years, depending on the structure of the skin.