Cheek-Midface Lift

  • Allen M. PuttermanEmail author


With age, the cheek migrates inferiorly and nasally. This contributes to inferior orbital rim hollowing, a circle effect to the lower eyelids and cheek, a flattening of the cheek, cheek bags (festoons), and nasolabial folds. In the past, these problems have been treated with facelifts, excision of cheek bags, and cheek implants. The cheek/midface lift procedure is performed by suspending an orbicularis muscle flap along with a tarsal strip. The operation places the ptotic cheek in a more normal position, relieves cheek bags, fills in the hollow inferior orbital rim with cheek fat, makes the midface more convex, and decreases the nasolabial fold depression. It also gives the effect of cheek implantation, adds skin to the lower eyelids for treatment of cicatricial ectropion, and reduces the hollowing of the lower eyelid that occurs sometimes secondary to overzealous fat removal in lower blepharoplasty. At times, the procedure is performed with lower eyelid fat excision, and at times, it is done with repositioning of the nasal and central lower eyelid fat pads into the inferior orbital rim hollowing area along with temporal fat resection. The tarsal strip procedure is performed to stabilize the lower eyelid and to prevent retraction and ectropion of the lower eyelid.


Cheek Midface Tarsal strip Eyelid circles Eyelid ectropion Fat repositioning Orbicularis flap Canthoplasty 

Supplementary material

419986_5_En_13_MOESM1_ESM.mp4 (260.9 mb)
Video 13.1 Drill hole midface lift. Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 267210 kb)
419986_5_En_13_MOESM2_ESM.mp4 (242.6 mb)
Video 13.2 Midface lift with Endotine midface B device. Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 248431 kb)
419986_5_En_13_MOESM3_ESM.mp4 (110.5 mb)
Video 13.3 Lateral tarsal strip. Courtesy of Richard C. Allen, MD, PhD, FACS. (MP4 113110 kb)


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OphthalmologyProfessor of Ophthalmology and Co Director Oculofacial Plastic Surgery, The University of Illinois College of MedicineChicagoUSA

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