Of all areas, the midface is one of the largest contributors to facial aging. The youthful midface is all about volume and plumpness. Young people have full and volumized midfaces and this is one reason they look young. In youth, we have the proper amount of fat in the correct places. As we age, we lose fat in the cheeks and gain it in the jowls. This loss of midfacial volume produces an aged, gaunt and hollow midface because the cheeks become the jowls! So as we age, you can say we go from a grape to a raisin.
Volume loss, changes in the bone and muscle and skin damage catch up to all of us. Volume loss can be easily illustrated by examining the family around you. This picture shows my 8 year old son, a 56 year old Dr. Joe and Joe Niamtu, Jr. at 83.
When we are young, our midface is naturally volumized and our lower face and neck are tight. A youthful facial outline looks like an upside down egg. With natural aging changes, we lose the midface volume and our lower face and neck becomes full. This produces a facial outline that resembles a right side up egg. Some may say egg foo young and egg foo old! Midfacial aging and volume loss is treated with cheek implants, injectable fillers, fat transfer and lifting procedures.
This patient was treated with mini facelift, upper eyelid surgery and cheek implants. Although all the procedures contributed to her rejuvenation, the cheek implants made the most dramatic impact as the restoration of midfacial volume is consistent with youth.