It’s almost a household name that facelift surgery can make you look younger. However, compared to the risks and complications of a major facelift, the popular “mini facelift” of recent years, the mid-face lift, is even more desirable for its minimally invasive, low-risk, dramatic results and short recovery period. The mid-face lift addresses the problem of mid-face aging. Aging of the midface is caused by sagging of the zygomatic fat pads with tissue translocation inward and downward, along with a decrease in the firmness and laxity of the skin and ligaments, resulting in sagging of the facial muscles including the zygomaticus major, zygomaticus minor, and levator ani of the upper eyelid. These changes increase the prominence of the nasolabial folds, visually flatten the zygomatic region, and result in the formation of a residual tissue called the “malar bag”. This thick layer of fat lies between the skin and the myofascial system (SMAS). Other changes include resorption of the maxilla and drooping of the corners of the mouth, leading to an increase in the longitudinal length of the lower lid. Therefore, we believe that aging of the midface includes the following 4 anatomical changes: sagging of the zygomatic fat pads, sagging of the lid-cheek structures, increased prominence of the nasolabial folds, and loss of fullness in the cheeks. Applicable groups for midface lift: 1, deep nasolabial fold; 2, drooping corner of the mouth; 3, drooping outer corner of the eye; 4, zygomatic bag subluxation; 5, orbital rim depression; 6, zygomatic prominence flattening; 7, deep naso-cheek sulcus; 8, eyebrow tail ptosis; 9, periorbital wrinkles. If you feel that the criteria of the applicable groups are too specialized to understand, then you can compare the following chart to see whether you have entered the group of people who need to be lifted, and you can envision the postoperative effect appropriately. PPDO in Midface Lift: The core of midface rejuvenation lies in the repositioning of the zygomatic fat pad, a triangular structure with the nasolabial folds at the base and the zygomatic prominence at the tip, located between the skin and the SMAS, and the lifting of this structure is the key to the midface lift. However, simple repositioning or excision of the SMAS does not correct midface tissue sagging well; therefore, new techniques have emerged to greatly improve the results of midface rejuvenation. The application of barbed wire, combined with fine endoscopic separation of small incisions within the temporal hairline, produces twice the result with half the effort.PPDO (poly p-dioxane) barbed wire is the newest generation of medical suture, with good biocompatibility, an absorption period of 180 days, higher resistance to tension and sustained performance, and bi-directional barbed wire, which lifts the muscles, tightens the skin, stimulates collagen proliferation, and the final decomposition of the components are carbon dioxide and water, a new anti-aging technology. How much lifting power does a single barbed wire have? See below: How does the surgery work? Preoperative preparation: 1, preoperative photo: orthostatic, left and right ortholateral position and left and right 45 ° oblique lateral position; 2, temporal area within the hairline routine skin preparation, braiding the hair in the surgical area (retaining the edge of the hair trace). Preoperative design: according to the degree of midface laxity and sagging, make incision marking lines within the temporal hairline on both sides, about 1cm long, and mark the separation range. Anesthesia method: intravenous general anesthesia combined with local swelling anesthesia technique. Surgical operation: lie on the back, disinfect and spread the towel, incise the scalp and subcutaneous tissues according to the temporal design line, bluntly separate to the superficial layer of the deep temporal fascia, avoiding the main temporal blood vessels, and tightly separate the superficial layer of the deep temporal fascia to the zygomatic bone, and start subperiosteal dissection in the zygomatic bone area, which is for the purpose of obtaining a better degree of tissue mobility when lifting in the next step. Under endoscopic guidance, barbed wires are placed along the stripping space to suspend the zygomatico-buccal fat pad, SMAS fascia, and zygomatic periosteum sequentially, and then fixed to the deep temporal fascia with upward pulling sutures. The skin was pressed with the palm of the hand towards the hairline to make the barbed wire fit tightly into the subcutaneous tissue. The use of endoscopy makes the whole separation process visualized, avoiding bleeding and local nerve damage. Preoperative precautions: 1, whether there is a history of serious diseases, must inform the doctor, if there is a year of physical examination report, can provide reference. 2. Avoid menstruation, or cold and fever. 3.If you are taking aspirin, hormone drugs, etc., inform your doctor in advance in order to choose the best time for surgery. Postoperative precautions: 1, breathable tape from the cheek to the temporal part of the fan-shaped lifting fixed mid-face skin for 3 days. 2, the operation area elastic bandage pressure bandage 2 ~ 3 days, 3 days after the operation can be given to intermittent ice packs to reduce the swelling of the operation area. 3 days after the hot packs to promote the swelling subsides. 3.Avoid large facial expression movements in the early postoperative period. 4.Return to the hospital one week after the operation to remove the sutures of the temporal small incision. 5, 3-5 days after the operation, there may be mild bruising around the eyes, is a normal phenomenon, hot compresses can promote its rapid dissipation. 6.Early localized slight depression formed by the pulling of barbed wire may appear, which may disappear gradually within one month.