The Selection of Facelift Approach on the Basis of Midfacial Ptosis

Vito C. Quatela, Nigar N. Ahmedli

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Facial aging in the midface has been described to encompass both soft tissue descent and volumetric change. Currently, there is no established and widely accepted grading system for midfacial ptosis. We propose a simplified grading system for midfacial ptosis ranging from mild to severe in terms of Grades I through III. Using this classification system, we describe an algorithm to help select the facelift approach most appropriate for each patient. The sub-superficial musculoaponeurotic system rhytidectomy, deep plane rhytidectomy, and subperiosteal midface lift techniques are described in detail. The nuances of the selection process also include a discussion on the various approaches to the orbital fat, namely a transconjunctival lower lid blepharoplasty with skin pinch versus a lower lid blepharoplasty with fat transposition, as well as the aging neck. Furthermore, we integrate the addition of postoperative adjunctive procedures which include injectables, chemical peels, and dermabrasion to address facial rejuvenation from not only a gravitational aspect but also the volumetric and textural components.

Original languageEnglish (US)
Pages (from-to)149-159
Number of pages11
JournalFacial Plastic Surgery
Issue number2
StatePublished - Apr 1 2021
Externally publishedYes


  • facelift
  • midface
  • ptosis

ASJC Scopus subject areas

  • Surgery


Dive into the research topics of 'The Selection of Facelift Approach on the Basis of Midfacial Ptosis'. Together they form a unique fingerprint.

Cite this