The Surgeon Minute

Improving The Mid Face With Fillers and Fat

Improving The Mid Face With Fillers and Fat

The lower eyelid and cheek junction is an area of the face that is often referred to as the mid face. It’s the region of the face that begins to show the signs of aging the earliest. Veteran board certified plastic surgeon Dr. Jason Cooper suggests a variety of cosmetic surgery treatments to help put your best face forward and improve your look.

The Aging Eye

When you look at someone’s face, what do you notice first? Perhaps it is the area smack in the middle of the face, bounded by the lower eyelid, the cheek bone, the top of the smile and the nose in the middle. This is commonly called the lower eyelid and cheek junction. It’s an area that gets a lot of attention, and also is the spot on the face that tends to age the earliest. “One of the first places where we begin to see facial aging in our 30’s is at the junction where the lower eyelid meets the cheek,” says Cooper. It’s the place where fat starts to atrophy first, and the cheeks subsequently begin to drop.

Losing volume in the mid face.

“That’s where the crease or trough forms between the lower eyelid and the cheek junction,” shares Dr. Cooper. He says the issue isn’t picky about who it afflicts between the sexes. “Both men and women seem to have this issue as they age.” He says patients will have dark circles, bags and wrinkles in these areas.

How to Treat “The Trough”

As with many plastic surgery treatments, there are many options to treat the lower eyelid and cheek junction. Some of them are non-surgical and some involve surgery. The proper choice will depend on the age of the patient and the extent of the rejuvenation required. Cooper says fillers can be a good option for some patients. “In the non-surgical patient, we use fillers – that’s typically a younger patient with good skin elasticity, without the presence of dark circles or hollows in the eyes.”

Fat transfer for the mid face.

He says very few people seeking treatment for this issue are good candidates for non-surgical repair. “I would say this makes up only about 5-10 percent of my practice when treating the lower eyelid, cheek junction area.” Cooper indicates that often it’s more appropriate to use surgical means to improve the area. “More commonly, skin needs to be removed, and fat or volume needs to be replaced within this spot.”

He says often patients who require surgery need fat injections to replace lost volume. “I think most patients are really surprised when I tell them they don’t need to remove fat from lower eyelids, we need to add fat to the upper portion of your cheek.”

Who Needs What, When?

Cooper says treatment is still very individualized, depending on age and specific goals. “As a general rule, usually patients in their mid 30’s to 40’s are the only people who I would consider with fillers. After that, I transition people in their mid to late 40’s and 50’s to surgical options or else they will be disappointed.”

Fat transfer to the mid face II.

The overall expectation is to create balance between all areas of the face with a youthful appearance. “We can really restore the harmony and the smooth transition from the lower portion of the lower eyelid into the upper portion of the upper cheek,” shares Dr. Cooper.

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