The treatment of facial aging is done by established procedures with long track records of success. These include the browlift (upper face), blepharoplasties (eyes) and the lower face. (facelift) The one area of the face to treat for sagging and loose tissue is the midface or cheek area. It is challenging because none of the traditional anti-aging facial procedures are designed to directly treat this area and the proximity of the lower eyelid also poses some anatomic concerns.
The many procedures that have been developed to lift the cheek area is a testament to the fact that there is no one universal technique that works in all cases. Cheeklifts (through the lower eyelid or from a combined temporal/inytraoral approch, malar/submalar implants, fat grafting and fillers have all been used extensively and each cheek rejuvenation method has it advocates and indications.
One of the least spoken about cheeklift methods, and also the ‘simplest’ is the preauricular hairline technique. By making an incision along the lower temporal hairline and back into the sideburn/preauricular tuft of hair, temporal skin can be removed which directly lifts the cheek tissue which lies anterior and inferior to it. This is a very powerful cheeklifting method even though it may only consist of skin removal.
The preauricular hairline cheeklift can be done as part of a facelift, after a facelift for residual cheek sagging or as an isolated procedure. Its obvious drawback is that it leaves a fine line scar along the lower temporal hairline whose visibiity depends on numerous factors. As a result, it is almost always best done in older female patients who skin is more loose with less elasticity.
Dr. Barry Eppley