Our Procedures

Surgical Procedures

Cheek Enhancement

What is an Endotine® 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, and lifestyle cause the skin, fat, and muscle in this region to move downwards.

When this occurs, the cheeks begin to look saggy or flat, 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.

The Endotine® Cheek Lift restores the natural curves and fullness in the cheeks by moving soft tissues back to where they were earlier.

This is achieved by elevating the soft midface tissue from the bone, repositioning it upward towards the eyes, and fixating it in place until it readheres naturally to the bone. This restores cheek volume and establishes more youthful midface contours. The result will be a natural, revitalized appearance that doesnt appear overdone or pulled.

When performed skillfully, a cheek 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 browlift. However, for many younger patients, under 45 years old, midface suspension is often a standalone procedure.

How is a Endotine® Cheek Lift Performed?

During a midface suspension procedure, the surgeon makes small incisions in the area above the ear or the lower eyelid and in some cases, through the underside of the upper lip. A small endoscope and other instruments are introduced through the incisions to lift the delicate midface tissues off the cheekbones. Once lifted, these tissues are repositioned upward (toward the eye) and to the side (toward the ear).

Midface suspension 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.

Am I an Endotine® Cheek Lift Candidate?

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 suspension. Of course the best way to determine if a midface suspension is right for you is by a thorough consultation with a surgeon.

The Endotine® Midface offers two new approaches to the midface suspension allowing your surgeon to quickly lift and secure tissue at a new, more youthful position. These innovative devices provide your surgeon with a predictable alternative for cheek suspension, enabling shortened procedure time and improved aesthetic outcomes.

The Endotine® Cheek Lift Solution The Endotine® Cheek Lift is a new approach that gives your surgeon the ability to easily restore sagging cheek volume to its natural position.

This new approach features the Endotine® Midface ST and Midface B devices, which 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. In this way, it can reduce the skin irregularities and dimpling that commonly occur when sutures are used. The tines also distribute the tissue forces evenly, minimizing the chance of surgical failure and possible injury caused by sutures.

It typically takes 30 to 60 days for the tissue to reattach to the bone. Once implanted, the device gradually absorbs until it is completely gone. This is an improvement over non-absorbable sutures, which remain permanently implanted long after they are no longer needed for fixation.

An experienced surgeon can place the Endotine® Midface device in minutes. This can shorten the length of the procedure by up to 30 to 40 minutes and possibly reduce the swelling associated with more prolonged techniques.

The tips of the tines are rounded to create a gentle grasping surface for the cheek tissue and reduce the chance of discomfort. While patients may feel the tines when they push down on the cheek, there is very little tenderness. Perhaps most importantly, patients report a very high level of satisfaction with their results.

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. The first night, it’s 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.

You can usually take a shower within a few days and most patients are ready to return to work in about two weeks. At this point, you may feel the Endotine® Midface device under the cheek, but it is not likely to be visible. It will become less palpable as it begins to absorb in the months following surgery.

How does the Endotine® Cheek Lift compare to a barbed-suture lift?

There are a number of differences between a true Endotine® Midface Lift and a barbed-suture lift. First, with the Endotine® Midface, the sagging midface tissue is released from the cheek-bone and repositioned at a higher (elevated) level. A natural healing process ensues that fixes the cheek tissue naturally at this new location. The result is a rounder cheek with more projection which translates to a more youthful appearance. Once healing has occurred, the Midface Device begins to be absorbed naturally by the body.

With barbed suture, there is no release of tissue, instead the suture passed through the cheeks upper tissue layer and then tightened by pulling upward. Cheek elevation is dependent upon the strings of suture being tied to the temporal area above the ear. Since there has been no movement of the underlying tissue to a new location, the long term results of this surgery has not been established. The suture is permanent, meaning it will remain under the skin until it is removed. Since the suture is constantly under tension lifting the cheek, it could remain palpable until removed. Once removed, the cheek would return to its original position

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Our Doctors

Board Certified Professionals

YADRO DUCIC, M.D. Facial Plastic
Reconstructive Surgery

Dr. Ducic is the Director of the Center of Aesthetic Surgery. Dr. Ducic is board certified in both Facial Plastic & Reconstructive Surgery and Otolaryngology-Head...

JESSE E. SMITH, M.D. Facial Plastic
Reconstructive Surgery

Dr. Smith is board certified in Head and Neck Surgery and board certified in Facial Plastic and Reconstructive Surgery. He has published a large number...