Midface Surgery Expertise

• Dr. Steinsapir is one of the key pioneers of midface surgery.
• In the past 15 years, surgeons have been grappling with what is essentially a new frontier in the field: midface surgery. In contrast to many of the classic techniques of periocular plastic surgery, midface surgery is still in a process of rapid evolution and flux.
• Dr. Steinsapir’s midface lift with hand carved ePTFE orbital rim implants is widely hailed. This workhorse procedure is often called upon for reconstructive procedures after unsatisfactory lower eyelid surgery and other complex reconstructive situations.
• It is important to understand that his extensive training and experience permit him to offer solutions that other surgeons lack the experience to perform. Dr. Steinsapir is often called upon to fix the midface work of other surgeons. He teaches other surgeons and lectures extensively.

Benefits

• Midface lift addresses the descent of the malar fat pad that contributes to the under eye hollow, the midcheek groove, the nasolabial fold and the jowl at the bottom of the cheek.
• As people age and their skin loses elasticity and tone, the cheeks and eyelids tend to sag, creating a tired or haggard look.
• The midface lift is a procedure to improve the look of the cheekbone area as well as the area underneath the eyelids. The Midface lift is a plastic surgery procedure that restores a smooth, youthful look to the lower eyelids and cheeks. It restores fullness to these areas and this makes the patient look younger.
• Many of the reasons lower eyelid surgery fails are due to a failure to appreciate the role of midface descent in the lower eyelid changes. Improving an unsatisfactory lower eyelid surgery almost always involves also addressing the midface issues and the lower eyelid.

Options

• Midface Surgery options include arcus marginalis release, tailored lower eyelid surgery, lower eyelid/midface chemical peel, fat transfer, midface surgery with or without an orbital rim implant.
• Arcus Marginalis Release: The lower eyelid fat is surgically rotated over the orbital rim to fill the under eye hollow. The surgery is performed from a small incision behind the lower eyelid and is comfortably performed under local anesthesia. Typically 10 to 12 days are required to recover from this procedure.
• Tailored Lower Eyelid Surgery: By carefully tailoring standard lower eyelid surgery it is possible for some individuals to improve the overall appearance of the lower eyelid as it transitions into the top of the cheek. This can be combined with a reinforcement of the orbitomalar ligament to improve bags that form at the top of the cheek.
• Vertical Midface Lift: Significant midface issues are addressed with a vertical midface lift over a hand carved ePTFE implant. This procedure is very effective for midface deficits following trauma, and prior lower eyelid and midface surgery. Patients who previously had cheek implants and have a hollow lower eyelid syndrome due to the placement of the cheek implants can significantly benefit by having their cheek implants removed at the time of vertical midface lift. Swelling from these procedure persists 2 to 3 weeks or longer but many feel ready to return to work in 10 to 14 days. A personal consultation with Dr. Steinsapir will determine if you would benefit from this procedure.
• Chemical Peel: Another highly effective midface option is a medium depth chemical peel that includes the lower eyelid, crows feet area and is feathered out over the cheek. Typically, phenol 89% is used for this purpose. Dr. Steinsapir is a master chemical peeler. These treatments are comfortably performed under local anesthesia. Recovery for this peel is 8 to 10 days before the skin is intact and able to hold makeup. Redness persists typically 6 to 8 weeks. While the redness is generally not an issue for men, women usually prefer to cover up the redness. The lower eyelid peel can be combined with a full-face peel for a truly awesome treatment with a very acceptable down time. The peel firms the lower eyelid skin tightening the midface and reducing lower eyelid fullness.

Minimally Invasive Options

• Restylane Lyft® is highly effective at treating almost all midface deficits without the necessity of surgery.
• These treatments last on the order of about a year. However, it is critical to get enough product in order to have a satisfactory result. How much filler is needed is entirely an individual consideration.
• Dr. Steinsapir will assess you and make a recommendation. Some will elect to do less treatment because of financial limitations. Dr. Steinsapir will work with you to get the most from whatever service you decide to afford yourself.
• Facial volumizing with the Hyaluronic sugar gels is less expensive than having surgery. Yet volumizing can accomplish results that can’t be obtained with surgery. Surgery and surgical recovery is avoided. For many, the downtime associated with surgery is a big consideration. These noninvasive methods truly provide a fantastic alternative to having midface surgery. Combine this with Microdroplet™ BOTOX® forehead lift. Think of this as the liquid face lift: surgery in a syringe.

Testimonials

• “I am a thirty year old actress and the roles I perform often call for a twenty year old. It is so great to have a non-surgical treatment that lets me look 10 years younger and no one knows that I am having my face done. Dr. Steinsapir is the best.” Anonymous
• “I only got smart after my first surgery. When I realized I didn’t heal correctly, I consulted everyone-literally everywhere. The plastic surgeons treated me like I was crazy or something. Dr. Steinsapir really understood my concerns and developed a surgical plan that made sense. I am now about a year out from surgery. My eyes close and my dry eye symptoms are so much better. Just as important, when I speak to people, they talk to me and look at me like I am a human being. I feel beautiful again thanks to Dr. Steinsapir.” BX

How does Dr. Steinsapir decide when to recommend noninvasive procedures and when to recommed surgery for the midface?

Generally, midface surgery is significantly more expensive than using facial fillers. When there is a profound deficiency in bone projection or loss of soft tissue due to prior surgery, Dr. Steinsapir favors a surgical approach. Otherwise, the noninvasive methods are preferred even if they only last a year or so before retreatment is necessary.

I have consulted other doctors and none of them seem to use a hand-carved implant. Why is Dr. Steinsapir’s approach so different?

Dr. Steinsapir is a pioneer of midface surgery. It is important to understand that his extensive training and experience permit him to offer solutions that other surgeons lack the experience to perform. This is why Dr. Steinsapir is often called upon to fix the midface work of other surgeons.

I consulted a surgeon who feels that all I need is a fat transfer to my midface and all of the issues will be corrected. Does Dr. Steinsapir offer this approach?

To address your particular concerns, a personal consultation with Dr. Steinsapir would be necessary. In general however, fat transfer to the under eye area has been relatively disappointing. The arcus marginalis release rotates a small volume of fat into the deepest portion of the under eye circle which is helpful. However, when the groove is profound, the arcus marginalis release will not provide a satisfactory degree of improvement. It is precisely these situations where the fat transfer has the greatest risk of post-procedure lumps and irregularities.

I broke my cheekbone several years ago. At the time, I had several surgeries to fix the break. Despite this, the repaired cheek has never been right and my eyelid on that side looks pulled down. Can midface surgery help me?

This is a situtation where midface lift can make an enormous difference. A personal consultation with Dr. Steinsapir will help determine what types of additional procedures you will need to get the best possible result.

I have bags in my lower eyelids. I have had several consultations and they seem split between eyelid surgery alone or eyelid surgery with a midface lift. I have never thought of filling the midface with Restylane® until seeing Dr. Steinsapir’s website. Why did none of the cosmetic surgeons I have seen recommend this option?

First, a personal consultation with Dr. Steinsapir will be very helpful because everyone is different. However, generally, Dr. Steinsapir will recommend the least invasive method he feels will achieve your goals. Recognize that the Deepfill™ developed by Dr. Steinsapir is a sculpting technique that requires a very detailed knowledge of midface anatomy to produce an ideal result. Not every cosmetic surgeon will be comfortable with this approach.

I had lower eyelid surgery that seemed to hollow out my lower eyelids and change the shape of my eyes. Another surgeon performed a lateral canthoplasty and did some fat transfer to my lower eyelid but the results have never been to my liking. I am wondering if Dr. Steinsapir’s midface surgery can help me?

At the risk of being repetitive, a personal consultation with Dr. Steinsapir would definitely answer this question. We generally recommend that you bring old photographs of yourself prior to the original surgery so Dr. Steinsapir can better understand your appearance prior to surgery. Dr. Steinsapir has been very successful in helping many people with exactly your set of issues so we encourage you to make an appointment for you personal consultation.