BLOG

 

Hello! “Designing natural beauty through trust.” I am Masataka Fujihashi, a board-certified plastic surgeon recognized by the Japanese Society of Plastic and Reconstructive Surgery.

 

As we get older,
"I feel like my face has gotten longer," "It kind of looks flat."
More and more people are coming to us for advice because they are struggling with issues like these.

 

Changes in the appearance of your face may be related to sagging in the cheek area, known as the midface. At Bianca Clinic, we offer a variety of cosmetic medical treatments to address changes in appearance caused by a loss of volume or sagging in the midface.

 

One such procedure is the “mid-face lift.” A mid-face lift is a surgical procedure that lifts the mid-face tissues, which have sagged due to aging, to improve the position of the cheeks and restore overall facial balance. The midface is an extremely delicate area where bones, fat, ligaments, and skin are intricately intertwined, requiring a cautious approach based on a thorough understanding of anatomy.

 

In this article, I’ll provide a detailed explanation from a plastic surgeon’s perspective on what a midface lift entails and why surgical procedures are effective for treating the midface.

First of all, where exactly is the midface? A crucial area that shapes the overall impression of the face

 

When we look at someone’s face, we unconsciously make intuitive judgments such as “They look young,” “They look energetic,” or “Do they look a little tired?” The key to a youthful appearance lies in an area known as the “midface.”

 

From here on, I’ll explain the specific areas that make up the midface—which are surprisingly little known—and why this part of the face plays such a key role in determining your “perceived age.”

The midface—the area “from under the eyes to the upper lip”—is the key area that determines a person’s facial appearance.

"Midface" is a technical term used in the fields of anatomy and cosmetic medicine that generally refers to the area from "under the eyes to around the upper lip." While this term may not be very familiar in everyday life, it is an important concept when discussing facial appearance.

 

The midface is located at the center of the face and refers to the area that maintains the balance of the eyes, nose, and mouth. The balance of this area determines the overall three-dimensional appearance and impression of the face. When the volume and relative positions of the midface are well-balanced, a natural three-dimensional appearance is created, resulting in a youthful look.

The Mechanisms of Mid-Facial Aging That Determine Perceived Age

The midface is also an area where changes tend to become apparent with age. As we age, the first noticeable changes are sagging and a loss of volume across the cheeks.

 

As the structures that support the fat lose their firmness, the cheeks begin to sag, altering the overall appearance of the midface. As a result, nasolabial folds may appear deeper, and the face as a whole may take on a stretched-out appearance.

 

Behind these changes lie not only changes in fat and skin but also changes in supportive tissues such as ligaments. As these supportive structures weaken, the entire tissue becomes more susceptible to the effects of gravity.

 

Furthermore, subtle changes in the skeletal structure that occur with aging are another factor that influences one’s appearance. These changes affect the overall three-dimensional contours of the face. These changes do not result from a single factor but rather from the combined effects of multiple factors.

 

As such, age-related changes in the midface are a complex phenomenon involving multiple structures—such as fat, skin, ligaments, and bone—and the visual impression is shaped by shifts in the balance among these structures.

What Is a Mid-Face Lift? | Features of the Procedure and Case Studies

 

We’ll explain the procedure and characteristics of a mid-face lift, as well as how it differs from the Hamra method. We’ll also use case studies to show how changes in the mid-face affect the overall appearance of the face.

A mid-face lift is a surgical procedure that targets deep tissues.

A mid-face lift is a surgical procedure that restores the mid-face tissues, which have sagged with age, to their original position. By correcting the sagging of the mid-face that occurs with age, this procedure aims to restore the face’s three-dimensional contours and create a more youthful appearance.

 

While a standard facelift primarily lifts the jawline and mouth area diagonally backward, a mid-face lift is characterized by its ability to reposition the mid-face—the central part of the face—vertically and slightly outward. The specific mechanisms and characteristics of a mid-face lift are primarily the following two points.

＜骨膜レベルの剥離によるアプローチ＞

The malar fat, located in the midface, is a thick, voluminous layer of fatty tissue. When we are young, ligaments support it like a hammock; however, as we age and this ligamentous support weakens, the fat sags due to gravity, becoming one of the factors that lead to a loss of volume in the cheeks and deepen the shadows of nasolabial folds.

 

A mid-face lift restores balance to the mid-face not simply by pulling the skin, but by carefully dissecting the periosteum and Malar fat in the deeper layers and adjusting their position.

＜深層固定による持続性の追求＞

The tissue, which has been dissected from the periosteal level, is lifted back into its original position and secured. By securing it at a deep level, we aim to achieve a natural three-dimensional appearance for the face and long-term results.

What Is the Difference Between a Mid-Face Lift and the Hamra Method?

Among patients seeking consultation for mid-face sagging or changes around the eyes, some consider a procedure known as the “Omo-Hamura method.” Although both procedures involve making an incision along the lower eyelid margin, they differ in their primary purpose and the area they target.

 

The Hamra procedure is a treatment that involves repositioning the fat in the lower eyelid (orbital fat) to smooth out unevenness under the eyes. It primarily targets dark circles (shadows and puffiness) under the eyes through a localized approach.

 

On the other hand, a mid-face lift is a procedure designed to realign the entire mid-face by lifting not only the area around the eyes but also the cheeks (including the malar fat pad). By lifting the underlying support structures from deep within, this procedure addresses not only under-eye sagging but also contributes to a change in the overall appearance of the mid-face, including nasolabial folds and the “Gorgon lines.”

 

In addition, since these procedures can sometimes be performed through the same incision line, depending on the case, combining them may be considered to simultaneously correct unevenness around the eyes and adjust the position of the cheeks. As a result, it becomes possible to create a more natural-looking three-dimensional contour from the eye area to the midface.

 

At Bianca Clinic, we propose appropriate treatment plans—including not only individual procedures but also comprehensive approaches—while taking into account the overall balance of your face.

 

▶For those who would like to learn more about the procedure and who is a good candidate for a mid-face lift.

▶If you'd like to learn more about Omote Hamura, please also check out the Omote Hamura treatment page.

Case Studies of Mid-Face Lifts

 

Here are some case studies from Bianca Clinic illustrating how changing the position of the midface can improve the overall appearance of the face. In the case study shown above, sagging was visible from under the eyes to the cheeks, and the lowered center of gravity in the midface gave the face a stretched-out appearance.

 

The mid-face lift lifted the cheek tissues, raising the position of the cheekbones and restoring balance to the mid-face. As a result, the cheeks now have a natural three-dimensional appearance, creating a more youthful look.

 

Who Is a Good Candidate for a Mid-Face Lift?

A mid-face lift is a procedure suitable for people with the following concerns:

• • For those whose cheeks have lost volume, making their faces appear flat
  • People who have a shadow (the "Golgo line") that runs diagonally from the hollows under the eyes to the cheeks
  • For those who feel that the nasolabial folds extending from the sides of the nose are becoming deeper and that sagging skin is covering the mouth area
  • For those concerned about sagging skin from the lower eyelids to the cheeks and a loose appearance around the mouth
  • For those who have not been fully satisfied with previous injection treatments or skin-tightening procedures

When addressing concerns related to changes in the midface, it is important to choose the appropriate approach based on the specific condition.

"Has my face gotten longer?"—That's a sign coming from the foundation.

 

A mid-face lift is a surgical procedure that lifts the tissues of the mid-face—which have sagged due to aging—to improve the position of the cheeks and restore overall facial balance.

 

As people age, many notice changes in the midface—the central part of the face. These changes may be related not only to the skin’s surface but also to the loosening of the underlying structures and changes in the bone in the deeper layers; as a result, it can be difficult to notice these changes with surface-level care alone.

 

That is precisely why it is so important to choose the right approach for your specific condition. At Bianca Clinic, we propose treatment plans tailored to each individual’s facial condition and preferences. Please feel free to contact us for a consultation.

 

▶Please contact us via the online reservation form.

▶Read other blog posts by Professor Masataka Fujihashi

 

[Professor Masataka Fujihashi's Social Media]

 

▶Instagram
▶X