Midface Lift (Subperiosteal) + Upper Eyelid Skin Excision (Upper Blepharoplasty)

Treatment details: Midface Lift (Subperiosteal) + Upper Eyelid Skin Excision (Upper Blepharoplasty)

Two separate problems were treated in one operation: descent of the cheek pad, and upper lid skin resting on the lashes. Working under the periosteum gives a firm plane to lift from, so the cheek travels vertically instead of being pulled toward the ear, and the junction between lid and cheek shortens without the face reading as stretched. The lid excision was deliberately conservative, because taking too much skin makes closing the eye at night difficult and flattens the fold. One month is early for a lift at this depth. Firmness over the cheekbone and swelling that is heavier on one side are both normal now and usually settle by the third month.

Releasing the midface under the periosteum produces heavy swelling and bruising across the cheeks and lower lids, worst in the first week and often a month before it clears. Numbness over the cheek while the infraorbital nerve recovers is common, and the two sides seldom settle at the same rate. Traction on the lower lid can round or lower the lid margin, and a temporary hollow may appear where tissue was freed. Scars inside the hairline can stay firm, and thinning of hair near the temple is possible. Removing upper lid skin can leave uneven creases, dryness, trouble closing the eye at night, or a visible line in the fold. Bleeding, infection and revision surgery are uncommon.