Botulinum toxin midface lift is a technique to correct sagging midface. The injected botulinum toxin contracts the lifting muscles by weakening the downward pull of the facial descending muscles thereby reestablishing the balance between the midface muscle groups and producing a compensatory lift of the skin. The selected patients have a sagging midface, which manifests as sagging cheeks with or without tear trough formation, or a groove in the mid-cheek with mild to moderate deepening of the nasolabial folds. Combined midface sagging of the jaw may also be seen. All patients were treated with botulinum toxin type A (Dysport_, Ipsen Limited, Berkshire, UK). Each vial of 500 U of botulinum toxin was prepared with 7 ml of fresh standard saline. A 1 ml syringe with a 32 Gauge needle was selected. The needle tip enters the dermis and injects the botulinum toxin, which can form small packets of 0.5cm in diameter. The technique is applied to the external side of the broad cervical muscle and orbicularis oculi muscle, injecting two parallel rows. For the vastus cervicis muscle, the outer line starts from the temporomandibular joint and goes down along the mandibular line with 1 cm between injection points. the inner line is 1 cm apart from the outer line, with the injection point between the two injection points of the outer line. For the outer orbicularis oculi muscle, injections are given along the outer edge of the muscle and in the temple area. The total amount of Botox injected on each side is 50-70 U. Intradermal injections of both descending muscles (cervicalis brevis and orbicularis oculi) can lift and rejuvenate the midface. The cheeks can be lifted by easing the grooves in the mid-cheeks and nasolabial folds, as well as trimming the face and making the skin smooth, bright and wrinkle-free. Improvements are very rapid and noticeable in some patients, but most patients show improvement within 5-10 days after injection, with more pronounced improvements in 1-2 weeks. Intradermal injections are indicated for flat, lamellar rather than fasciculated muscles, especially if these muscles are atrophied or less pronounced. It is also indicated when skin laxity or loose skin tone is very poor. The fact that intradermal injections cannot eliminate all wrinkles, but only alleviate them to maintain the function of some muscles, is precisely its benefit for patients who want to maintain a natural expression and do not mind leaving some wrinkles behind. Furthermore, the intradermal injection technique is relatively safer for some of the more dangerous areas of the face. Finally, this technique can be used as an alternative to conventional intramuscular techniques that are not suitable for everyone to reconstruct the contours of the face and neck. When Botox (Allergan, Irvine, CA, USA) is used, it is better to prepare it with 5 ml of saline. The total amount of Botox needed to inject both the broad cervical muscle and the orbicularis oculi is 20-30 U per side. However, each Botox has its own characteristics – how the response begins, what the results are and how long they last may vary.