Midface Lift/Hammock lift
WHAT IS A HAMMOCK LIFT AND MIDFACE LIFT?
The concept of a “Hammock Lift” was presented by Prof. BCK Patel at a Plastic Surgery Meeting and then developed with presentation of surgical results to illustrate the importance of looking at the face as a whole, rather than in parts.
In basic terms, the Hammock Lift achieves an improvement in the forehead, the brows, the frown lines, the upper eyelids, the lower eyelids, and the midface which includes a midface lift: in other words, there is improvement of the top two-thirds of the face in a congruous fashion. We also include fat grafts and skin treatments (CO2 laser, peels, etc as needed) to give a 3-D improvement in the top two-thirds of the face.
WHAT IS A MIDFACE LIFT AND HOW IS IT A PART OF THE HAMMOCK LIFT?
Also known as cheek lifts, midface lifts are designed to give the natural fullness back to the cheeks, to improve the groove that occurs with aging below the lower eyelids and lift the mid and lateral part of the face. This is best illustrated photographically in the following before-and-after photographs.
Plastic surgeons have concentrated on upper and lower blepharoplasties and lower face and neck lifts and have long ignored the midfacial structures. Dr. Patel, together with others studied this midfacial ages and developed and published surgical techniques which have helped improve the results of facial rejuvenation.
Essentially, the brow lift and upper blepharoplasty together with fat grafts improves the contour and structure of the upper third of the face, and a lower blepharoplasty and midface lift improves the middle third of the face. Fat grafts, lasers and other skin treatments are also performed to give a three dimensional improvement in the structure of these parts of the face.
“Well, the last time I had a picture taken I could hardly see my eyes because of the weight of heavy eyelid. Then I paid attention to how I was actually using my eyes and I really noticed when I was looking at anything especially the computer I was straining my forehead to see better. Since I have had it done I no longer have to lift the forehead and tilt my head to see. It is amazing! I love…” D. Rock 63 Yrs Old with Fat Droopy Eyes – Salt Lake City, UT
THE BEAUTY OF THE MIDFACE IN A HAMMOCK LIFT: ANALYSIS AND EXPLANATION
It is understandable that people don’t like heavy brows, or frown lines, or baggy eyelids or jowls or loose necks. What is often forgotten by people and by plastic surgeons alike is the importance of the midface and how it gives definition to the face. Analysing what constitutes beauty in the middle of the face allows one to understand why we instinctively know when a face we look at looks beautiful.
1. This is the fullness so important in the brow. There has been a tendency to remove brow fat pads when plastic surgeons perform upper blepharoplasty or browlifts: this is a mistake. We, on the other hand, always augment the brow with fat grafts during surgery to give this nice fullness back again. Aging results in decompression of the brow fat pad.
2. This is the all-important malar mound or fullness. It has a particular shape and position that must be understood by the persnickety plastic surgeon if he/she is to achieve the best results. Just below this malar fullness sits a hollow that is possessed by all models! Look up photographs of any female models and you will be struck by the consistency of the presence of the malar fullness and the sub-malar hollow. We therefore try to recreate both of these, even in patients who never had them as it just makes the face more beautiful!
3. This is the sub-malar hollow discussed above.
4. The submalar hollow leads to the firm convex jawline. Therefore, the midfacial anatomy is multicontoured: the face or the mid face should not be just pulled as has often beendone. These contours, hills and valleys must be constructed to give the ideal result.
We designed the “Hammock Lift” to improve the top two-thirds of the face: the brows, the upper eyelids, the lower eyelids and cheeks. This only leaves the lower facelift and necklift to be performed later to give a total facial rejuvenation. The Hammock lift gives amazing three-dimensional results with proportionate improvement of the face…
“My Hammock Lift is exactly what I needed, but did not know!! Dr. Patel explained to me how the Hammock Lift improves the upper two-thirds of the face, including brows, upper lids, forehead, lower lids and cheeks. I also got an improvement along my jawline which I am thrilled with as I plan on having a lower face and necklift later but this already gets me a great improvement. I have sent my two sisters to him! Brilliant surgeon. Cannot speak highly enough about him and his team. ” J. Stevenson “Top marks”– Park City, UT
AM I A CANDIDATE FOR A MIDFACE LIFT?
POWER OF THE NECK
It is for this reason that I stress that the “money is in the neck”. The better the neck I give you, the better your face looks. Of course, some improvement of the neck may be obtained with local neck procedures, but the best improvement of the neck is obtained by performing a proper face and necklift.
“I have spent time today reviewing your point-by-point description of everything you did for me and how you did it; I referred to the before and after photos countless times. I am in absolute awe. Your facelift results are nothing short of miraculous. You are absolutely correct, If you had told me what you intended to do, I would have most likely taken a pass from being confused and fearful of the results. You have a gift. Your skills are beyond my comprehension. You have taken a woman, me, who had spent the better part of 15 years being injected with Juvederm to ward off my hereditary jowls, then the signs of aging. I had gotten to a point, that there was not enough Juvederm to keep up with my aging process. I had resigned myself to forever having my Grandmother’s jowls. I became discouraged. Though I loved Grandma dearly, I did not love her jowls. I also never realized I had such a gobble neck not seeing myself in 3-D on a regular basis. Then I discovered your gifts through Marlene. Though I had always said I would never, ever get a face lift due to fear of a possible adverse outcome, the joy and confidence, plus the fabulous results from Marlene sealed the deal. I can’t even begin to tell you how very pleased and joyful I am by my results thus far and I know they will only improve with time. Thank you for doing such an amazing job for me and on me! “ -Toni J
HOW WILL I BE ASSESSED FOR A HAMMOCK LIFT AND MIDFACE LIFT?
WHAT OTHER PROCEDURES MAY BE PERFORMED WITH A MIDFACE LIFT?
Patients may benefit from attention to upper eyelids (upper blepharoplasty), forehead and brow lift, cheek lifts, face and neck lifts, fat injections, laser resurfacing, and other facial and neck procedures. Please do not hesitate to ask us questions about any other aspects that may bother you. We always remind all our patients: no one NEEDS cosmetic surgery. But if you decide you would like to see an improvement in any aspect of the face, we will pay close and careful attention to ensure only appropriate and safe procedures are performed.
In the presence of a deep groove and ptosis of the cheek, it is unwise to perform just a lower blepharoplasty: your results will be ho-hum! In such instances, a midface elevation with fat transfer combined with a lower blepharoplasty gives the best result. If this applies to your anatomy, it is
important to identify the factors before undergoing surgery!
Hammock Lift Results: Fat grafts and surface lasers are often used together with midface lifts to give the best results.
UNDERSTANDING THE "HAMMOCK LIFT" WHICH INCLUDES A MIDFACE LIFT WITH A CASE STUDY
This patient was bothered by “my face”. However, specifically, she wanted an improvement in her forehead, upper eyelid looseness, lower eyelid bags, lip lines and jowls. But she did NOT want a facelift and necklift just yet.
HAMMOCK LIFT PERFORMED
This is a combination of a forehead/brow reshaping combined with upper and lower blepharoplasty and a technique of midfacial tissue repositioning we have developed with not only recreates the cheek fullness of youth whilst reducing the lower fat “bags”, but also helps with lower facial and jowl improvement. We routines use skin treatments (lasers, peels, etc) to improve the overall improvement of the face.
This is not meant to be a replacement for a lower face and necklift which is what is needed to get the best jawline and neck, but this combination of procedures we have been using on our patients allows us to manage the face in two halves: the “Hammock Lift” first, which gives excellent results. Followed by a lower facelift and necklift when the patient is ready.
A split-face image showing the right side of the face before and the right side of the face flipped on the left after surgery so a direct comparison may be made. The improvement in the lip wrinkles (smoker’s lines) and skin is from the use of fractionated CO2 laser at the same time as the Hammock Lift procedure
2. We analyze the whole face and neck and aim for harmony as people don’t look only at your neck or cheeks.
3. With advanced training and detailed knowledge of aging, anatomy and physiology, we are much better able to address said changes with a view to a congruous outcome that lasts.
4. The skin is what everyone immediately sees: it is impossible to hide blemishes, deeper wrinkles, sun-spots, age-related discolorations, broken veins, large pores with make-up. We pay particular attention to getting the skin to look its best.
5. If necessary, the face and neck are broken up into thirds so you understand if the improvement is best broken up into two separate treatments. This reduces your anaesthesia time for any given procedure and also allows us to give you the best results as explained on the “Facial Aging” page.
6. We combine the use of fat grafts, tissue repositioning, volume augmentation, fat repositioning and removal where appropriate, proper tissue transfers, avoidance of pull-lines and three-dimensional tissue relationship positioning to give us results seen on this and other pages of our patients.
I HAD A FACELIFT DONE BY SOMEONE BUT I HAVE PROBLEMS AND I AM NOT ENTIRELY HAPPY WITH MY RESULTS. WHAT CAN I DO?
THE HAMMOCK LIFT
“My Hammock Lift is exactly what I needed, but did not know! Dr. Patel explained to me how the Hammock Lift improves the upper two-thirds of the face, including the forehead lines, the brows, the upper and lower lids and the cheeks. I also got an improvement along my jawline which I am thrilled with as I plan on having a lower facelift and necklift later but this has already given me a terrific improvement. I have sent my two sisters to him! Brilliant surgeon: can’t speak highly enough about him or his excellent team.”
J. Stevenson “Top Marks” – Park City, UT
WHAT KIND OF RESULTS CAN I EXPECT AFTER A HAMMOCK LIFT?
The aim is to achieve a congruous balance between the forehead, the upper eyelids, the lower eyelids and the cheeks. A nice benefit of a well-performed cheek lift is the improvement one sees in the lower part of the face. Whilst the midface lift is no substitute for a lower facelift and neck lift, in those patients that don’t (yet) need a lower facial procedure, it is an excellent “side-benefit”.
THE HAMMOCK LIFT: MIDFACE REJUVENATION WITH BROW LIFTS AND UPPER & LOWER BLEPHAROPLASTY
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As midface lifts are often performed in combination with other procedures, most patients receive general anesthesia.
With a 3-D procedure, there are several layer of sutures, accurately placed to give the lifting, tightening and filling, without leaving any tell-tale pull-lines. Some are slow dissolving sutures, others are more permanent. The skin sutures are generally removed between 7 and 14 days.
- Bruising and swelling are de rigeur! However, significant long-lasting complications are rare.
- Bleeding is not common as we pay close attention to proper hemostasis. On rare occasions, a small hematoma may collect.
- Everyone will experience some numbness in the face: this resolves over weeks. All faces have asymmetry and there will be some degree of asymmetry. This is to be expected.
- Permanent weakness of nerves and muscles is rare.
- The scars are usually very well hidden. However, some patients may have a tendency to cause hypertrophic scarring: in such cases, certain lasers and treatments will help. By-and-large, scars are rarely a problem. With Caucasian skin, pinkness of scars is to be expected for several weeks. With darker skin, some hyperpigmentation may occur.
In the first few days, everyone will experience some degree of dryness and blurry vision. You will also feel that your lids look a little tight on the outer corner where you will also feel some of the deeper sutures if you put your finger there: this is of no concern. The tightness and the bumps under the skin settle over a few weeks.
More serious complications which are very rare include excessive bleeding, hemorrhage and loss of vision.
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CONTACT DR. PATEL
Do you have questions or need more answers?
Dr. BCK Patel MD, FRCS
Salt Lake City, Utah 84106, USA
(801) 413-3599 (phone/text)
Dr. BCK Patel MD, FRCS
617 E Riverside Dr Suite 101
Saint George, UT 84790, USA