Endoscopic Mid-Face Lift in Turkey

The mid-face is the triangle between the lower eyelid, the nose and the corner of the mouth. As it ages, the malar fat pad slides downward off the cheekbone. That single movement creates three of the features people most dislike: a hollow under the eye, a visible transition between lid and cheek, and a deepened fold running from nose to mouth.

A conventional facelift pulls tissue backward toward the ear and does relatively little for this area, because the vector is wrong. A mid-face lift moves the tissue vertically, which is the direction it fell. That is the whole rationale, and it is why the two operations are complementary rather than alternatives.

How it compares

What the package includes

• Surgeon and anaesthetist fees
• One night in a private hospital room
• All pre-operative blood tests
• Endoscopic equipment and fixation devices
• Seven nights in a four-star hotel with breakfast
• All airport, hotel and hospital transfers
• A personal English-speaking coordinator
• Antibacterial mouthwash for the intraoral incisions
• Suture removal before you fly home
• Twelve months of remote aftercare

Why the stay is eight nights

Longer than most facial procedures, and not because the operation is bigger. Mid-face swelling is notoriously prolonged and lopsided — patients often look worse at day five than day two, and asymmetric swelling causes a great deal of unnecessary alarm. Having your surgeon see you through that period is worth more than getting home two days earlier.

A mid-face lift is usually suitable if

• Your cheeks have flattened and the fullness has moved downward.
• You have a hollow or dark shadow under the eye caused by the cheek dropping away.
• The fold from your nose to the corner of your mouth has deepened.
• Your jawline and neck are still reasonably tight.
• You have tried fillers and want something structural rather than repeated.
• You are a non-smoker, or can stop at least four weeks before surgery.

Another procedure may suit you better

• You have jowls or a loose neck: a mid-face lift does nothing for either. A deep plane facelift addresses both plus the mid-face.
• Your problem is volume loss rather than descent: fat transfer replaces volume, which lifting cannot.
• You have lower eyelid bags: eyelid surgery with fat repositioning may be the primary operation, with or without a mid-face lift.
• You want a modest, reversible change: fillers achieve a lot in the mid-face for far less commitment.
• You have had previous mid-face or lower eyelid surgery, which makes dissection less predictable.
• You cannot accept two to three weeks of visible, uneven swelling.

Our self-check below gives you an honest starting answer, and a Valentmedica plastic surgeon reviews your photographs free of charge and will tell you if a different operation suits you better.

1. Marking: with you sitting upright, your surgeon marks the cheek pad, the planned vertical vector and the fixation points. The vector matters — lifting outward rather than upward produces a widened, unnatural look.
2. Anaesthetic: a consultant anaesthetist puts you to sleep. The mouth is prepared with antiseptic because one incision is intraoral.
3. Temporal incision: a two-centimetre incision behind the temporal hairline, invisible once healed.
4. Intraoral incision: a small incision inside the upper lip above the canine tooth, giving access to the cheek from below. No external scar.
5. Endoscopic dissection: a camera is passed through the temporal incision and the tissue over the cheekbone is released from the bone under direct vision, down to the orbital rim and the upper fold.
6. Releasing the retaining ligaments: the ligaments anchoring the cheek pad in its descended position are divided. Without this release the tissue simply springs back and the lift does not hold.
7. Repositioning and fixation: the cheek pad is lifted vertically and secured — usually with sutures passed up to the deep temporal fascia, or with absorbable fixation devices. This is what holds the result.
8. Checking symmetry: assessed with you positioned upright on the table before closing.
9. Closing: the temporal incision is sutured; the intraoral incision is closed with dissolving sutures.

• Days 1–3: swelling across the cheeks and under the eyes. The face feels tight and the upper lip is numb from the intraoral incision.
• Days 4–6: swelling peaks and is frequently uneven, with one cheek noticeably more swollen than the other. This is normal and causes a lot of unnecessary worry.
• Week 2: swelling begins to settle meaningfully. Soft food continues while the intraoral incision heals.
• Weeks 2–3: most patients are back at a desk job. Residual swelling in the cheeks is still visible to you if not to others.
• Weeks 4–6: light exercise restarts. Chewing is comfortable again.
• Months 2–3: the cheek contour becomes clear as the last swelling resolves.
• Months 6–12: the final result. Mid-face swelling genuinely takes this long to disappear completely.

Valentmedica works only with JCI-accredited private hospitals in Istanbul and with plastic surgeons registered with the Turkish Ministry of Health who hold Turkish Society of Plastic, Reconstructive and Aesthetic Surgeons membership.

Risks you should know about

• Prolonged swelling: not a complication but a genuine feature, lasting months rather than weeks.
• Asymmetry: common temporarily from uneven swelling, and occasionally persistent.
• Lower eyelid changes: the lift can pull on the lower lid, causing rounding or scleral show, particularly in patients with lax lids.
• Numbness: of the upper lip and cheek, from the intraoral approach. Usually temporary.
• Infection: uncommon, but the intraoral incision means mouth hygiene matters.
• Facial nerve injury: rare with endoscopic technique, usually temporary when it occurs.
• Under-correction: where retaining ligaments were not adequately released, the lift relapses.
• An unnatural, widened look: from an outward rather than vertical vector.

Tell your surgeon if you have lax lower eyelids or have had lower eyelid surgery before. A mid-face lift exerts downward traction on the lid, and in that situation a canthal support procedure is usually added.

The mid-face sits between the eyes and the jawline. Treating it alone can emphasise an untreated brow above or an untreated jowl below, which is why it is rarely performed in isolation in patients over about fifty.

Commonly combined with

• Lower eyelid surgery: the most natural pairing, since both address the lid-cheek junction. A canthal support stitch is often added to protect lid position. See eyelid surgery.
• Brow lift: completes the upper face. Both are endoscopic and share the temporal incision. See brow lift.
• Fat transfer: lifting repositions tissue but does not replace lost volume. Grafting to the temples, tear trough and cheek adds what lifting cannot. See fat transfer.
• Facelift: for patients who also have jowls and a loose neck, though a deep plane facelift may address everything in one operation.

If your surgeon recommends a deep plane facelift instead of a mid-face lift, that is usually sound advice rather than an upsell. The deep plane technique lifts the mid-face as part of the same flap, and for anyone with jowls it does considerably more for a comparable recovery.

• Dental check: the intraoral incision sits above the canine tooth. Any active dental infection should be treated before surgery.
• Smoking: stop at least four weeks before and after. Facial flap healing depends on blood supply.
• Medication: tell your surgeon everything you take. Blood thinners, anti-inflammatories, fish oil and vitamin E all increase facial bruising.
• Fillers: tell your surgeon if you have had mid-face filler and when. Existing filler affects both the assessment and the dissection.
• Soft food: plan a fortnight of it. The intraoral incision makes chewing uncomfortable, and you will want soup, eggs and soft fish ready.
• Time off: plan two to three weeks. Mid-face swelling is prolonged and visible.
• Packing list: a travel pillow to keep your head elevated, antibacterial mouthwash, soft foods and your medication in its original packaging.

When it works, the change is specific and subtle: fullness returns over the cheekbone, the shadow under the eye softens because the cheek now supports the lower lid, and the fold beside the nose becomes less of a crease. Patients describe looking less tired rather than looking different, which is the right outcome.

Longevity depends on how thoroughly the retaining ligaments were released and how securely the tissue was fixed. A lift that relies on tension without proper release relapses within a couple of years; one that is properly released and fixed holds for five to ten. Ageing continues around it, and volume loss will carry on regardless of position — which is why combining with fat transfer gives a more durable overall result than lifting alone. You can see three and twelve month comparisons in our before and after gallery.