Lidlift Kenneth D. Steinsapir, M.D.
Cosmetic, Facial & Eye Plastic Surgery

Midface Ptosis

Literally downward sagging of the malar fat pad. The malar fat pad is held in place by the orbitomalar ligament. Over time these ligaments loose their grip on the malar fat pad which begins a gradual descent down the cheek. This is the cause of midface ptosis. There are a variety of midface lifts, the goal of which are to correct this fall in the malar tissue. The big problem with many of these surgeries is that the theory behind many of these surgeries is wrong. The malar fat pad falls down vertically. Many midface surgeries don’t lift vertically because there is nothing great to sew to at the inferior orbital rim. Dr. Steinsapir gets around this problem by attaching a piece of ePFTE felt to the orbital rim with titanium microscrews. This creates a place to sew the vertically lifted cheek soft tissue. However, most midface lifts actually involve a superior lateral lift because there is very good fascial tissue to sew to in the temple region. The surgeries work in the sense that the tissue stays up-that’s the good news. The bad news is that the malar fat pad looks real funny when it gets dragged up over the cheek bone. The look is generally described as dysmorphic (doctor talk for not quite right).