Ageing: a well-defined facial oval is the secret to ageless beauty

Midface lift: redefining the facial oval

The recent National Congress of the Italian Society of Reconstructive and Aesthetic Plastic Surgery addressed anti-age research, examining data on body-image perception.

The midface lift (or lifting de pommettes) may be a solution, with procedures limited to the facial oval. Focusing solely on the jawline and neck is an outdated concept. To rejuvenate the face, attention should be placed on the ideal oval which, from brow to mouth, has long represented the aesthetic ideal in drawing.

Tissues lose tone and sag with age, creating neck wrinkles, yet what truly draws attention are the eyes and the mouth. So what does a midface lift involve? A multidisciplinary approach starting from psychology and body-perception studies, touching aesthetic medicine, and culminating in plastic surgery.

Traditionally, to refresh a face the surgeon first acts on tissues that have descended with age, blurring the mandibular line and creating neck wrinkles. But recent perception studies show these are not the areas that attract the patient’s attention, which focuses almost exclusively on the oval that includes the eyes and mouth.

In short, working on peripheral zones is of limited use. And acting does not necessarily mean heavy use of the scalpel. According to a less invasive approach, facial rejuvenation is achieved by combining several treatments and procedures:

  • Sectional (limited) facelift, leaving a small scar in front of the ear at the sideburn area;
  • injections of botulinum toxin to smooth forehead lines when needed;
  • Autologous fat grafting to revitalise tissues and restore facial fullness.

For many years, facial rejuvenation has included autologous fat transfer, harvested from areas where it is naturally present (abdomen, flanks, etc.), refined, and placed in the cheeks or zygomatic areas, which naturally lose volume over time.

When combined with a lift—i.e., repositioning tissues that have descended with age—lipofilling restores youthful fullness and, thanks to the action of adult stem cells contained in fat, activates a regenerative process that improves tissue elasticity and vitality, making them visibly younger.

Results can be even more striking by choosing a specific harvesting and transfer technique—so-called nano- and micro-lipofilling. Using ultra-fine cannulas, transfer is feasible and effective even in delicate areas such as the eyelids, which regain tone without resorting to the scalpel, contributing to an overall impression of rejuvenation.