Aesthetic Plastic Surgery

, Volume 36, Issue 6, pp 1277–1282 | Cite as

Persistent Improvement in Lower Eyelid–Cheek Contour After a Transtemporal Midface Lift

  • Evan R. Ransom
  • Benjamin C. Stong
  • Andrew A. Jacono
Original Article Craniofacial/Maxillofacial



This study aimed to assess quantitative changes in lower-eyelid aesthetics after a transtemporal midface lift concomitant with transconjunctival blepharoplasty and lower-eyelid skin pinch.


The study enrolled 55 consecutive patients who underwent a transtemporal midface lift and concurrent transconjunctival blepharoplasty with lower-eyelid skin pinch. All the surgeries were performed over a 2-year period by the senior author (A.A.J.). Patient demographics and surgical details were recorded. Standardized digital photographs were taken at baseline and then 12 months postoperatively. These were analyzed to assess changes in the vertical height of the lower eyelid and compared using within-subject analysis.


The study cohort consisted of 50 women with a mean age of 54 years (range, 28–76 years). Five patients were lost to follow-up evaluation. The mean vertical height of the lower eyelid was 11.8 mm preoperatively and 9.3 mm postoperatively, giving an average difference of 2.5 mm at the 12-month follow-up assessment. The changes in lower-eyelid height were statistically significant (p = 0.0002), and the lower eyelid–cheek contour was improved in all cases. No major complications occurred during the study period, and no revision surgery was performed. Lower-eyelid height changes did not vary significantly with patient age.


Age-related changes to the midface are marked by increased vertical height of the lower eyelid and a concomitant appearance of infraorbital hollowing. Separation of the lower eyelid–cheek complex causes the typical double-contour deformity. To the authors’ knowledge, no study to date has reported the long-term effect of a midface lift on lower-eyelid aesthetics. The transtemporal midface lift not only repositions the malar fat pad but importantly also provides significant shortening of the lower eyelid at 12 months. This results in an improved midface contour.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Aging face Blepharoplasty Lower eyelid Midface Midface lift 



We thank Harriet Feldman, RN, and Cathy Moskowitz, RN, for their years of hard work and support in the operating room, helping make the described surgeries possible.


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Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2012

Authors and Affiliations

  • Evan R. Ransom
    • 1
    • 2
    • 3
    • 8
  • Benjamin C. Stong
    • 4
  • Andrew A. Jacono
    • 1
    • 2
    • 5
    • 6
    • 7
  1. 1.Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology/Head and Neck SurgeryAlbert Einstein College of MedicineBronxUSA
  2. 2.Section of Facial Plastic & Reconstructive SurgeryNorth Shore University HospitalManhassetUSA
  3. 3.Long Island Jewish Medical CenterNew Hyde ParkUSA
  4. 4.Kalos: The Atlanta Center for Facial Plastic, Reconstructive, & Laser SurgeryAtlantaUSA
  5. 5.Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology/Head and Neck SurgeryNew York Eye and Ear InfirmaryNew YorkUSA
  6. 6.New York Center for Facial Plastic & Laser SurgeryNew YorkUSA
  7. 7.New York Center for Facial Plastic & Laser SurgeryGreat NeckUSA
  8. 8.San Francisco Center for Facial Plastic, Reconstructive, & Laser SurgerySan FranciscoUSA

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