Complex Surgery continued...
According to Shan Baker, MD, president of the American Academy of Facial, Plastic and Reconstructive Surgery and director of the Center for Facial Cosmetic Surgery at the University of Michigan in Ann Arbor, "The facelift has changed radically in the last 15 years." Doctors, he says, are now performing surgery under the deep facial muscle tissues to achieve "a more natural, less operated-on look."
The new operation is becoming more common "because of the feeling that there was an imbalance in the upper face and lower face in traditional facelifts," Baker explains. "[The mid-facelift] was supposed to give a flatter, more youthful look at the fold from the lower eyelids along the sides of the nose and down." But, he says, that claim is debatable.
Does It Work?
The surgery itself takes about 60-90 minutes. According to Jacobs, it begins with the same lower eyelid incision, just under the eyelashes, that starts a traditional facelift. Working through that incision, he says "I like to go all the way down, past all the tissues to the corner of the mouth. And this is where the mid-facelift differs: I lift up the entire cheek and put the stitches on the inside and attach them to the bone around the eyelid socket area, all on the inside."
Why do it this way? "This procedure allows me to clean up the eyes and clean up the fold and lift up that cheek tissue that tends to descend as time goes on," Jacobs explains. By comparison, he says, "The classic facelift involves incisions around the ear and back into the hair and does very little on the fold of the midface around the nose."
But according to Baker, there's not much evidence that the mid-facelift produces the kinds of improvement that some doctors claim. "The theory is that you're left with a very smooth lower eyelid, which flows right into the cheek, and a softer, more natural-looking nasolabial fold," he says. "But that is a point that is debated; and many doctors feel that the complexity of the procedure is not worth the benefits, which many see as negligible."
Jacob disagrees: "A good way to think about this operation is kind of like an introductory way into plastic surgery to deal with the first signs of aging."
Since it's a cosmetic procedure, the mid-facelift isn't covered by health plans: It costs around $7,500, depending on where you have it done.
The side effects are the same as those of a traditional facelift -- swelling, bruising, inflammation, and pain. In rare cases, there might also be nerve damage, and sometimes a second procedure may be needed to make corrections to treated areas. In general, Jacobs says, "People go back to work within a week."