Endotine Midface Patient Information

Endoscopic Midface Lift Procedure

Using the Endotine Midface Fixation Device

What is a midface lift (also called a cheek lift)?

The area between your lower eyelids and your mouth is considered the midface. As you age, the effects of gravity, repeated muscle contraction, lifestyle and genetics cause the skin, fat, and muscle in this region to move downwards. When this occurs, the cheeks begin to look saggy or flat; the lower eyelids can become puffy or hollow; circles begin to appear under the eyes; and the lines between the nose and the corner of the mouth deepen.

A midface lift procedure restores the natural curves and fullness in the cheeks by lifting the soft tissues back to where they were in more youthful times. This is achieved by elevating the soft midface tissue from the bone, repositioning it upward towards the eyes, and affixing it in place while it adheres naturally to the bone.

This procedure restores cheek volume and establishes more youthful midface contours. The result is a natural, revitalized appearance that doesn’t appear overdone or “pulled.” A midface lift will deliver a natural but noticeable improvement. It is frequently performed with other surgeries, such as a lower face lift, eyelid surgery, or a brow lift. However, for many younger patients, under 45 years old, midface rejuvenation is often a stand-alone procedure.

The Endotine Midface solution

The Endotine Midface lift is a new approach that gives surgeons the ability to easily restore sagging cheek volume to its more youthful position by using a temporary bioabsorbable implant, instead of sutures. The Endotine Midface device is smaller than a dime and has five small tissue holders, or tines, to grasp the cheek tissue gently but securely and elevate it (and all overlying cheek tissue layers) to a new position. The Endotine device can reduce the skin irregularities and dimpling that commonly occur when sutures are used to hold tissue in place. The tines also distribute the tension forces evenly, minimizing the chance of surgical failure and possible injury caused by sutures.

Typically it takes 30 to 60 days for the lifted tissue to reattach to the bone. During this time, the Endotine device gradually dissolves until it is completely absorbed by the body. This is an improvement over non-absorbable sutures, which remain implanted long after they are needed for fixation. Endotine implants are made from a substance called polylactic acid, which is produced from plant materials to create a bio-plastic substance that dissolves naturally and is absorbed by the body.

The tips of the tines are rounded to minimize discomfort and to provide a gentle grasping surface for the cheek tissue. While patients may feel the tines prior to dissolving when they push down on their cheek, there is very little tenderness.

How is an Endotine midface lift performed?

During a midface lift, the surgeon makes as few as two tiny incisions in the area above the ear, and in some cases, through the underside of the upper lip. A tiny camera called an endoscope is introduced through one of the incisions, and another surgical instrument is introduced through another of the incisions to gently lift the delicate midface tissues off the cheekbones. The Endotine device is then inserted under the soft tissue to grasp and hold the cheek’s soft tissue as it is lifted upward (toward the eye) and to the side (toward the ear), into a more youthful position.

Midface lift surgery is often performed in office-based surgical suites, and can be done with general anesthesia or with local anesthesia and sedation. Patients typically return home on the same day. Surgical dressings, if used, are removed soon after surgery, and any tissue swelling related to the procedure gradually diminishes.

I’m happy with it… I definitely look 10 years younger. When the swelling first started going down, I saw myself the way I used to see myself… It was like, ‘There you are!’
—Julia, Age 43

Advantages of an Endotine Midface lift

  • No large, visible incisions like a conventional face lift
  • Long-term rejuvenation that will last years
  • A powerful rejuvenation effect that looks natural, not “done”
  • Easily combined with other procedures such as a brow lift or neck lift.
  • Excellent aesthetic control of cheek elevation and projection
  • Gentle, secure tines distribute tension evenly, reducing skin irregularities caused by sutures
  • Uses your own tissue instead of synthetics
  • No need for removal, since the Endotine Midface device dissolves naturally over time, and is absorbed into the body

Am I a candidate for an Endotine Midface lift?

If your cheeks are sagging or have flattened over the years, if your lower eyelids are puffy with dark circles or have “hollowed out,” or if your smile lines have deepened, you’re probably a good candidate for a midface lift. Of course the best way to determine if a midface lift is right for you is by thoroughly consulting with your surgeon.

The Endotine Midface offers a unique way to establish a more natural, rejuvenated look. The procedure offers virtually invisible incision locations (above the ear hidden in the hairline, and sometimes through the underside of the upper lip) so if you’re combining midface rejuvenation with another procedure or just considering the midface alone, there will be no visible incisions or scars after your surgery.

With years of successful clinical use documented in a number of medical journals, the Endotine Midface has demonstrated unmatched reliability in helping surgeons and patients achieve their aesthetic goals.

This innovative device replaces conventional suture and allows your surgeon to more accurately reposition your cheek while securely holding the soft tissue in position during the critical, early stages of healing.

What can I expect after surgery?

Immediately after surgery, you will experience some temporary swelling and bruising in your midface region, which may take several weeks to completely resolve. A small, limited number of patients have experienced a “slight puffiness” that may last several months and gradually fades over four to six weeks.

Patients typically return home on the same day. Surgical dressings, if used, are removed soon after surgery.

During the first few nights it is important to rest with your head elevated to decrease swelling and bruising. You can use a cold compress for comfort and to help control swelling. Additionally, pain medication may be prescribed for post-operative pain. Also, for the first three to four days, you should limit your diet to softer, easier-to-chew foods. This will also help reduce swelling.

You can usually take a shower within a few days and most patients are ready to return to work in about a week to 10 days. It is advisable to limit physical activities such as exercising or bending over for extended periods of time for the first week after surgery.

It typically takes 30 to 60 days for the cheek’s tissue to completely reattach in its new and elevated youthful position. During and after this healing has occurred, you may still feel the “tines” of the Endotine when you push downward on your cheek. There may also be tenderness in the first month or so when you do this but just remember that over time, the Endotine will naturally dissolve and be absorbed by your body. Perhaps most importantly, patients report a very high level of satisfaction with their results.

My hope is that my vitality on my face will reflect how I feel. When your cheeks sag, you look tired, no matter how you feel.
—Joy, Age 46

I’ve had other procedures but this was just so easy. I would do it again tomorrow.
—Clay, Age 47

Possible risks associated with the Endotine Midface lift

Although the Endotine Midface device is designed for cheek-lift surgery, it’s important to understand that there are potential risks inherent in this (and all) midface suspension procedure(s). For example, you may experience some initial discomfort, regardless of the method used, and you may be able to feel the Endotine Midface device under the cheek skin, which may be sensitive to the touch. The Endotine Midface device is designed to minimize the risk of injury to bodily structures in the surgical area, although these structures are at risk with any technique. Should problems occur that are specifically associated with the Endotine Midface device, you and your surgeon may decide to remove the device rather than wait for it to dissolve.

Information contained in this brochure is intended to provide you with a better understanding of the midface suspension procedure. This is not intended as a substitute for medical advice. The best way to get complete information and answers to your specific questions is through a personal consultation with your surgeon.


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