In most patients who require an incision on the lower eyelids for their blepharoplasty, it is cosmetically beneficial to perform concomitant midface (cheek) lifting. Midface lifting is performed through the same incision as the lower eyelid blepharoplasty. Performing blepharoplasty without simultaneously performing a midface lift can sometimes give an “elongated” appearance to the lower eyelids. Most importantly, the midface lift can further support the lower eyelid and is an additional step to help prevent any postoperative eyelid malposition. In some cases, lower eyelid malposition cannot be adequately repaired without performing midface lifting as part of the surgical solution.
Midface lifting can also sometimes make up for a shortage of skin in the lower eyelids, for example, after a blepharoplasty in which too much skin has been removed.