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2026.05.26
To avoid failure in a mid-facelift: Risks and judgment points considered by doctors
As a plastic surgeon certified by the Japanese Society of Plastic and Reconstructive Surgery, I have been involved in many cases of trauma, reconstruction, and congenital diseases, and have cultivated precise techniques and a deep understanding of anatomy. He entered the field of cosmetic surgery out of a desire to bring the power of cosmetics to his patients, as a change in one's appearance can also make one's mind more positive. Her specialties include general treatment of the eye area, injections, and sagging skin. I provide treatments that focus on beauty with the medical stance of "sincerely addressing the ideals of the patient.
Hello!
Designing natural beauty with trust.
I am Masataka Fujihashi, a board-certified plastic surgeon of the Japanese Society of Plastic and Reconstructive Surgery.
When you hear the term "mid-face lift," some people might feel, "It seems like it will really lift things up," while others might feel anxious, thinking, "I'm scared of failure." In fact, during consultations, we frequently receive questions like, "Won't it look unnatural?" and "Will it revert back?"
A mid-face lift can fundamentally improve sagging in the mid-face, but as it is a surgical procedure, it also carries risks. However, we believe that if the characteristics and suitability of the surgery are correctly understood and it is performed appropriately, there is no need to worry unnecessarily. This time, we will explain the possible risks and failure cases of mid-face lifts, as well as the important considerations for preventing them.
What is a mid-face lift? A surgery that lifts the mid-face from the root.
First, let's clarify how mid-face sagging occurs and how a mid-face lift brings about changes.
Why does the mid-face sag?
The midface, from under the eyes to the cheeks, is one of the areas most susceptible to the effects of aging. While sagging is often thought of as "excess skin," that's not the whole story. Aging causes the following changes, which ultimately result in the entire cheek area dropping.
- Bone volume reduction
- Fat atrophy or displacement
- Support organization slack
As a result, it appears on the surface in the form of dark circles under the eyes, gorgon lines, and parentheses lines. In other words, it is important to view mid-face sagging as a structural problem, not a skin problem.
How does a mid-face lift surgery work?
A mid-face lift is a surgery that repositions the sagging tissues of the mid-face by dissecting them and securing them to a stable layer, such as the periosteum. Instead of just pulling the skin, the soft tissues are lifted as a whole, so
- The line from under your eyes to your cheeks becomes smoother.
- Leads to fundamental improvement of bags and sagging
The following changes can be expected.
What are the "failures" that can occur with a mid-facelift? Risks you should know about
When considering a mid-face lift, many people are concerned about "what changes could occur if it fails."
As with any surgery, there is a certain level of risk involved. However, by understanding the potential complications in advance, you can help alleviate unnecessary anxiety. Here, we will outline the main risks that require clinical attention.
Example Failure 1: Cases where scars are noticeable
As this is a surgical procedure that involves an incision, there is always a risk that scarring may be noticeable. We typically choose less visible areas for incisions, but depending on your individual constitution and how you heal, redness or raised scars may remain.
Failure Example 2: Tugging/Strained, Unnatural Expression
If the direction of the lift or the fixation point is not appropriate, you may experience an unnatural feeling when you laugh. The so-called unnaturalness from "lifting too much" is related to this part.
Failure Example 3: Cases with Left-Right Differences
Since faces are not perfectly symmetrical to begin with, any pre-existing asymmetry may remain after surgery. Also, if there are differences in the degree of depression or the amount of fat between the left and right sides, it may be difficult to completely eliminate the asymmetry even after surgery.
Example of failure ④ Postoperative complications such as hematoma and infection
Complications such as hematomas (blood clots) and infections may occur after surgery. While not frequent, these are complications that require prompt attention.
Failure Example 5: Nerve Trouble
The midface has important nerves running through it. Although extremely rare, impacts on these nerves can potentially lead to sensory abnormalities or changes in movement.
Why do failures occur with mid-facelifts?
It's not just with mid-face lifts, but the results of cosmetic surgery aren't determined by the surgical technique alone. In reality, multiple factors contribute to the final outcome, including pre-operative judgment, design, and determining suitability for the procedure.
Here, we will outline the key points that make a difference in mid-facelift results and the cases for which it is suitable.
Key factors influencing mid-facelift results
A mid-face lift is a relatively difficult surgery, and the outcome is significantly influenced by several factors.
- Doctor's experience
- Preoperative evaluation and counseling details
- Design of the release layer and fixing position
- Choosing the right technique for each condition
- Preoperative condition (left-right difference, degree of indentation, amount of fat, etc.)
Therefore, as each patient's skeletal structure and sagging condition differs, a one-size-fits-all approach to surgery is not appropriate, and individual judgment is necessary.
Cases where a mid-facelift is considered
If the cause of under-eye dark circles and marionette lines is midface drooping, a midface lift can be an effective option. However, it is not suitable for all dark circles. If skin tone (such as pigmentation or thin skin) is the issue, the discoloration is likely to remain even after a midface lift or transconjunctival fat repositioning (also known as a "fat bag removal").
Frequently Asked Questions about Mid-Facelift
Regarding mid-facelifts, we receive many questions during consultations. In particular, "How long do the results last?" and "Will it return to its original state?" are points that many people are concerned about.
Here, we'll answer frequently asked questions from a clinical perspective.
Does a mid-face lift have a relapse?
Since aging itself cannot be stopped, changes will occur in the long term. However, when performed appropriately, the changes tend to progress in a way that resembles natural aging rather than a significant reversal.
How long do the effects of a mid-face lift last?
Depending on the procedure and individual differences, the effects tend to be long-lasting because they directly address the cause of sagging. The ability to achieve long-term changes with a single surgery is a significant advantage.
What is the downtime and recovery period for a mid-face lift?
After surgery, swelling and bruising may be visible for about two weeks. Significant swelling will gradually subside, and it will take several months for the results to settle into a natural appearance. While recovery varies from person to person, it's important to consider the timing in relation to your own schedule.
Is a mid-face lift necessary for people in their 20s?
Essentially, the treatment is for drooping due to aging, so there are few cases where it is applicable for people in their 20s. However, it may be applicable in cases of skeletal factors.
Is there a non-surgical mid-face lift?
Thread lifts, HIFU, and Voluma are sometimes chosen as "non-surgical lifts." However, their effects and duration differ compared to surgical procedures.
Key points to prevent mid-face lift failure
When considering a mid-face lift, it's important to determine if it's truly suitable for you. With that in mind, we recommend checking the following points:
- Do you understand anatomy?
- Is there an explanation that includes risks?
- Do you post before-and-after photos of HA super-SMAS lift and mid-face lift on social media?
- A doctor who clearly explains what can and cannot be done.
Summary: How to avoid failure with a mid-face lift
A mid-face lift is a surgical procedure that addresses sagging in the mid-face. However, the difficulty of the surgery is also high, making it important to carefully assess suitability and design the surgical procedure. Rather than choosing based on a vague feeling that it "seems good," confirming whether it is truly suitable for your condition is key to preventing failure and achieving a satisfactory outcome. It's also important to consider cases similar to your own, referencing before-and-after photos. If you're concerned about sagging, please consult with us for a consultation.
