Is there any cure for mid-face aging? What are the differences between endoscopic mid-face lift and transorbital mid-face lift? A comprehensive analysis of surgical principles, treatment scope, and effects.

As people age, many begin to notice subtle changes in their appearance in the mirror: under-eye bags and tear troughs become more pronounced, nasolabial folds deepen, and once-full cheeks show signs of sagging. They may even feel their face is longer and more tired than before. In fact, these changes are often not just a problem in a single area, but rather a result of "mid-face aging"!

The midface is a crucial area supporting facial contours and a youthful appearance. When ligaments loosen, fat shifts, and soft tissue sags, it can cause prominent nasolabial folds, tear troughs, and eye bags. This can further affect the lower face, corners of the mouth, facial contours, and overall face shape, making one look older and less energetic. Therefore, midface lifting has become an important treatment option for facial rejuvenation in recent years, with "Endoscopic facelift"and"Mid-face lift with eye bags"The two surgeries are the most frequently mentioned."

Although both surgeries are midface rejuvenation options that can improve midface sagging, there are significant differences in their surgical incisions, treatment areas, suitable patient groups, and improvement effects. Which one is more suitable for you? This article will start by analyzing the causes of midface aging and delve into the principles, features, and indications of the two surgeries to help you find the most suitable midface rejuvenation solution for you!

What are the symptoms of aging in the midface? 

The mid-face generally refers to the middle section of the face, from the lower eyelid to the nasolabial junction (including the sides of the nose). It is an important area for maintaining a youthful appearance. However, with age, facial ligaments loosen, fat shifts, and collagen is lost. The original supporting structure changes, and the once full mid-face gradually shifts downward, leading to the following common problems: 

1. Nasolabial folds deepen

After the originally smooth and full apple cheeks sag, the nasolabial folds become more and more obvious due to the displacement of volume and the compression of gravity. 

2. Loss of cheekbone volume

The mid-face support decreases, and the face loses the three-dimensionality and plumpness of its youthful appearance. 

3. Deepening of tear troughs

The loss and sagging of tissue below the eye sockets creates a noticeable hollowing effect. 

4. Eye bags are more noticeable

When the support in the mid-face weakens, the orbicularis oculi muscle under the eyes sags as it loses the support of ligaments and fat pads.，This leads to decreased muscle tension, making eye bags more prominent. 

5. Downturned corners of the mouth

Aging is a holistic process. When the midface sags and droops, the lower face is often affected in the same way. Sagging midface and lower face can make one look tired, serious, or even depressed and aged.

What are some common mid-face lift surgeries? 

I. Endoscopic facelift 

Surgical principles 

Endoscopic facelift is performed by...A small incision hidden within the hairline on the temporal side.Using a high-resolution endoscope, the procedure involves deep tissue dissection to reposition and fix sagging mid-face tissues upwards. Because it addresses the root cause of mid-face aging, it effectively improves under-eye sagging, mid-face drooping, and loss of cheekbones. It can also reduce the formation of nasolabial folds and the pressure on early-stage jowls.  

Advantages and features 

✔ The wound is hidden within the hairline. 

✔ The lifting direction matches the tissue position when the patient was younger. 

✔ Can simultaneously improve signs of aging in the mid-face and around the eyes.

✔ The effect is natural and lasts a long time. 

Suitable for ethnic groups 

• Early to moderate aging population aged 35-55  
• Those whose nasolabial folds gradually deepen  
• People with sagging cheeks  
• Those with severe mid-face aging and eye bags  

II. Mid-face lift combined with eye bag removal (eye bag removal combined with mid-face lift) 

Surgical principles 

Mid-face lift via blepharoplasty involves making an incision during blepharoplasty to suspend and fix the fat in the eye bags, the tissue around the eyes, and some soft tissue in the mid-face. Its biggest feature is that it can improve eye bags while also moderately lifting the local mid-face tissue under the eyes. 

The main areas of improvement include prominent eye bags and sunken tear troughs (requires fat grafting), making it very suitable.Mild drooping of the midfacePeople who are chosen as treatment options. 

Advantages and features 

✔ Resolves eye bags and localized under-eye sagging in one treatment 

✔ No additional hairline scarring required 

✔ Fast recovery after surgery via blepharoplasty (eyelid bag incision)

Suitable for ethnic groups 

• People with obvious eye bags  
• Mild mid-face drooping  

Endoscopic midface lift vs. midface lift via blepharoplasty

The biggest difference between endoscopic facelift and transorbital facelift lies in the location of the incision, the direction and extent of the lift, and whether eye bags can be addressed simultaneously.，If the main symptoms are under-eye bags and tear troughs, and the aging of the mid-face is not severe, a mid-face lift with under-eye bags can be chosen to improve under-eye bags and mild mid-face sagging. 。 

若For those with more severe nasolabial folds, sagging cheeks, and overall midface laxity, endoscopic midface lift with minimal incisions usually provides more comprehensive improvement.。

Mid-face aging is not a single problem; a comprehensive treatment approach can achieve a more natural and youthful appearance.

Many people believe that improving localized issues like nasolabial folds or eye bags can achieve a youthful appearance. However, facial aging is a holistic process. When the midface becomes visibly loose and sagging, it's not just the midface area that's affected; aging problems also appear on the upper face, around the eyes, lower face, and even the neck.

For the upper face, common changes include drooping eyebrows and eyes, eyebrows pressing down on the eyes, sagging eyelids, and the gradual narrowing of originally prominent double eyelids, making the eyes look tired and lifeless. Around the eyes, problems such as protruding eye bags, sunken tear troughs, and drooping eye corners may appear, making one look older.

As the midface loses support, the lower face is also affected, leading to deeper marionette lines, fat accumulation around the mouth, and a blurred jawline, making the facial contours less defined. If aging continues, the neck will also sag and loosen, resulting in a "turkey neck" problem, creating a difference in the youthful appearance between the face and neck.

Therefore, a professional facial rejuvenation surgery assessment is not just about treating a single area. Instead, it involves an experienced plastic surgeon designing a customized treatment plan based on the degree of aging, tailoring a rejuvenation solution to the individual's specific needs, and achieving a natural and harmonious rejuvenation effect.

▼Including a one-stop facial rejuvenation case study with mid-face lifting▼

Mid-face aging is not simply a matter of deepening nasolabial folds or prominent eye bags; rather, it is a holistic aging phenomenon caused by the gradual loss of support and downward displacement of deep facial ligaments, fat, and soft tissues. Therefore, both endoscopic mid-face lifts and transorbital mid-face lifts have their own suitable candidates and treatment goals, and there is no absolute superiority or inferiority among them.

For individuals concerned about mid-face aging, rather than simply comparing which surgical procedure is better, it is more important to undergo a comprehensive evaluation by a specialist physician who is proficient in eyelid surgery, facelift surgery, and facial rejuvenation treatments. Through overall facial structure analysis, assessment of the degree of aging, and consideration of individual circumstances, the true root cause of aging can be identified, allowing for the development of the most suitable and appropriate treatment plan.

At Arsty Clinic, a team of doctors specializing in facial rejuvenation surgery will personally assess your case. Among them are Dr. Wei-Cheng Ching, who specializes in full-face lifts, Extended Deep Plane Facelifts, Swan Neck Lifts, neck lifts, facelift revisions, and one-stop facial rejuvenation surgeries; and Dr. Hsin-Yu Chen, who specializes in eyelid surgery, blepharoplasty, Endoscopic Forehead Lifts, and one-stop periocular rejuvenation surgeries. They will tailor a customized treatment plan based on your individual aging patterns and needs, helping you regain a natural, harmonious, and youthful facial contour that suits your personality. Welcome to schedule a consultation!