Cheek and Midface Lift

How does the midface age?

The midface is an essential component of an attractive face. With the aging process, the fatty tissue that normally drapes over the cheekbones can begin to sag with gravity. The result is less prominent cheekbones, and a droopy fold of skin and fat between the nose and the cheek (the nasolabial fold). The sagging cheek fat can also alter the appearance of the lower cheek. For example, bagginess of the lower eyelids often becomes more apparent after the fat of the upper cheek begins to sag. This in essence 'unveils' the bagginess of the lower lids, which have always been there. In addition to sagging of the skin and fat of the midface, there is also volume loss from the cheek with aging, due to loss of cheek fat and muscle.

Midface aging is due to both sagging and volume loss from the upper cheekEarly midface aging in a woman of her 40s

Schematic drawing and actual photo of midfacial aging - note how the aging in the midface is related to a combination of laxity and volume loss. The tear trough (1) and loss of cheek prominence (2) are direct consequences of this process

A number of cheek lift or midface lift procedures may be performed either alone or in combination with other procedures. The goal is to reposition the sagging fat of the cheek over the cheekbone to restore the youthful fullness of the cheeks. The procedures include suture meloplication or percutaneous cheek lift, endoscopic cheek lift, subperiosteal cheek or midface lift, feather lift suture suspension, malar augmentation with lift, and SOOF lift.

What can a cheek lift achieve?

Using minimally invasive cheek and midface lift techniques with limited incisions, the droopy cheek tissue can be lifted up over the cheekbone restoring the more prominent youthful contour, improving the tear trough and bagginess of the lower lids, and softening the undesirable cheek fold.

Before cheek lift, upper and lower blepharoplastyAfter cheek lift, upper and lower blepharoplasty

Before                                                  After
* Individual results may vary.

Why should you choose a facial plastic surgeon?

Although most plastic surgeons today perform facial surgery, very few actually limit their practice to specialize in the face. Dr. Naficy limits his practice 100% to facial plastic surgery. This is why Seattle doctors voted Dr. Naficy one of the top plastic surgeons for the face. Dr. Naficy has a global patient base, attracting patients from all over the country and internationally.

Cheek Lift Photo Gallery

You may wish to browse through the gallery of representative before and after cheek and midface lift pictures. Click on any of the thumbnails to enter the slide show. All procedures were performed by Dr. Sam Naficy and some patients may have had more than one surgical procedure performed. The text accompanying the photos describes the details of the procedures performed.


* Individual results may vary.

Subperiosteal Midface Lift

This is a deep technique of midface and cheek lift where all the tissue are lifted from the cheekbones and re-suspended in a higher place. Incisions are made inside the mouth and in the temple. This midface lift technique can have a moderate degree of swelling associated with it and the swelling may take a few weeks to disappear.


The SOOF (sub-orbicularis oculi fat) is an acronym for the fatty tissue of the uppermost part of the cheek, next to the fatty tissue of the lower cheek. SOOF lift can be performed through the same incisions used for cheek surgery. This midface lift technique typically has less swelling associated with it.

Endotine Midface Suspension

This technique involves use of an absorbable implanted device that aids in maintaining the position of the tissues after a cheek and midface lift. The device is typically used with the subperiosteal midface lift. The main advantage of the Endotine midface lift over other midface and cheek lift techniques is that it provides a more effective method of holding up the lifted tissues compared to traditional sutures. Dr. Naficy was one of the first few surgeons in the country performing the Endotine midface lift procedure.

Endotine Midface liftEndotine Midface lift

Endotine Midface lift

Mini Face Lift

A mini face lift, or S lift is a technique of lifting early jowling of lower face with limited incisions and minimal skin removal. Patients with minimal laxity (typically early to late 40s) may be good candidates for this procedure. This type of lift is more similar to a face lift rather than a midface or cheek lift.

Featherlift Of Cheek

This technique is performed with a needle and thread technique that does not require any incisions. Specially designed threads with barbs (like on a fish hook) are used to tighten the skin from the underside. The procedure can be performed under local anesthesia and patients can drive themselves home after the procedure.

Percutaneous Cheek Lift

This technique is a minimally invasive method of lifting the cheek and midface region. The procedure requires no visible incisions and may be performed in an office setting with minimal sedation and a rapid recovery period. The percutaneous cheek lift or percutaneous midface lift is performed using suture loops placed under the skin of the midface. This technique is also called midface meloplication.

What procedures may be combined with a cheek lift?

Cheek lift procedures may be safely combined with a number of other facial cosmetic procedures including blepharoplastybrow liftface and neck liftcheek augmentationlip augmentationneck liposuction, and laser resurfacing.

What type of anesthesia is used?

We use IV sedation anesthesia, which is a very safe and effective method of anesthesia for facial plastic surgery and rhinoplasty. IV sedation anesthesia is extremely safe compared to the standard general anesthesia techniques used today. The main advantages of IV sedation anesthesia are: (i) it does not require putting a breathing tube in the throat, (ii) it does not require a breathing machine, (iii) the recovery is much faster, (iv) there is much less "hang-over" from anesthesia, (v) and there is much less nausea. All these elements translate into greater comfort and safety. Dr. Naficy has used this technique of anesthesia in several thousand plastic surgery procedures without any anesthetic complications.

During IV sedation anesthesia a small flexible IV (intravenous) needle is placed into one of the veins of the back of the hand. Through this IV line, relaxing medication is given to make you fall sleep. The amount of medication given is adjusted to the specific needs of each person. After you are sleeping, some numbing medicine is also placed in the skin to numb the area that is being operated on. The beauty of IV sedation anesthesia is that during the procedure you are unaware of anything going on and cannot hear anything, yet you are still breathing on your own.

When the procedure is finished, the relaxing medication is discontinued and you begin to wake up. Because the medications used in IV sedation anesthesia clear the system rather quickly, most of our patients are typically able to go home in less than 30 minutes after the procedure is completed.

Anesthesia guidelines [21kb PDF]

What is the recovery like?

Most patients experience minimal discomfort after the procedure. Discoloration is minimal. Majority of the swelling will generally improve over 5-7 days, but it will take several weeks for all the swelling to resolve. Most individuals will be able to return to work and social activities within 7-10 days although some swelling will still be present.

Post-operative care instructions [12kb PDF]

I am interested! What do I do next?

If you are considering this procedure we encourage you to complete this Surgical Consultation Intake Form. Dr. Naficy will tell you whether you are a suitable candidate for this procedure and inform you of the potential risks of the procedure. You will also have a chance to view before and after photo albums of his patients who have undergone procedures similar to what you are considering.

Out of Town Patients

If you are among many of our out of town patients and are considering this procedure we encourage you to complete this Surgical Consultation Intake Form. After carefully reviewing your photos, Dr. Naficy will inform you of your options. We regularly treat patients from Los Angeles, San Francisco, New York, Miami, and London. For most procedures a weeklong stay is typically adequate. Private and luxurious accommodations are scheduled for you by our patient care coordinators.

RealSelf Top Doctors Logo
Best of Western Washington Logo