Midface Sagging
Midface sagging is the descent of the malar fat pad and overlying soft tissues of the cheek due to progressive attenuation of the zygomatic retaining ligaments and the orbitomalar ligament. This produces flattening of the cheek eminence, deepening of the nasolabial fold, and elongation of the midface.
Understanding Midface Sagging
The midface — the anatomical region between the lower eyelid and the upper lip — is the first area to show visible signs of facial aging in many patients. The youthful midface has a full, convex cheek contour that sits high on the malar eminence. With aging, the malar fat pad descends medially and inferiorly, pulled by gravity and propelled forward by the weakening of the zygomatic retaining ligaments. The tear trough hollow deepens as the orbitomalar ligament releases its support, and the nasolabial fold transforms from a subtle anatomical groove into a deep crease as the descended cheek tissue stacks against the fixed upper lip.
Endoscopic midface lifting — performed through small incisions hidden in the temporal hairline — provides powerful and natural midface rejuvenation without the scars and prolonged recovery of traditional facelift approaches. Istanbul's endoscopic facial aesthetic surgeons perform high-volume midface lifting at a fraction of Western costs.
Treatment Options for Midface Sagging
View All ProceduresAesthetic Impact of Midface Sagging
The aesthetic consequences of midface sagging extend well beyond the cheek. As the malar fat pad descends, it pulls the lower eyelid skin with it, deepening the tear trough and producing a hollow, tired appearance. The nasolabial fold deepens, creating a shadow that draws the eye downward. The face loses its youthful heart-shaped contour and takes on a longer, flatter, more rectangular appearance. The distance between the lower eyelid margin and the nasal ala (the "midface height") increases, and the cheek appears deflated, losing the convexity that is a hallmark of youth. Many patients also notice accentuation of the marionette lines as the descended midface pulls on the oral commissure.
Treatment Options at Vellum Select
Endoscopic Midface Lift
The gold-standard treatment for midface sagging is Endoscopic Facial Lifting in Turkey. Through 3–5 small incisions (1–2 cm) hidden within the temporal hairline, the surgeon releases the zygomatic retaining ligaments under endoscopic visualisation, mobilises the malar fat pad superiorly, and re-suspends it to the deep temporal fascia. The result is a natural elevation of the cheek contour, softening of the nasolabial fold, and improvement of the tear trough — all without external incisions. Recovery is typically 7–10 days, and the results last 8–12 years.
To discuss your midface sagging with a Vellum Select facial aesthetics specialist, contact us to arrange a consultation.