Midface Lift/Hammock lift


A Hammock lift is a concept we developed in human cadaver studies of the aging of the face. This was then applied clinically and we presented and published this technique in meetings and journals the world over. 

A Hammock Lift achieves the following:

  • Improves forehead lines, frown lines, and brow positions
  • Improves the laxity of skin and fat in the upper eyelids and the lower eyelids
  • Improves the cheek positions and cheek fullness which we lose with time
  • Improves the lower face and jawline as a bonus (see our photographs of patients’ results
  • Improves the texture of the skin and pores

Instead of breaking the face up into small areas which increases the number of procedures and costs for patients, we developed this Hammock Lift which essentially improves all the structures abouve the mouth, up to the hairline!

Most patients will then have us do a lower face and neck lift some months later and this then give a fully rejuvenated face. 

“Well, the last time I had a picture taken I could hardly see my eyes because of the weight of heavy eyelid. Then I paid attention to how I was actually using my eyes and I really noticed when I was looking at anything especially the computer I was straining my forehead to see better. Since I have had it done I no longer have to lift the forehead and tilt my head to see. It is amazing! I love…”  D. Rock  63 Yrs Old with Fat Droopy Eyes – Salt Lake City, UT

This nicely illustrates how our “Hammock Lift” approach to the midface recreates the malar fullness (mound) and also created the sub-malar hollow. This gives structure to the face. Even in an older patient, elegance is returned to the face!


We hear complaints about frown lines, heavy brows, baggy eyelids, jowls and loss of neck firmness. We tend to divide the face and neck up into lots of little sections. Instead, we developed the concept of improving the face in a balanced manner so that the result is one of a youthful face without telltale signs. 

The fullness in the brows and the midface (cheeks) must be recreated to make any blepharoplasty of the upper or lower lids or forehead lift look good. 

1. Fullness of the brows is seen in all young faces. Removal of the brow fat was promoted by a number of plastic surgeons and this was a major mistake. For some years we have published and lectured on the technique of recreating beautiful brows with a natural fullness, often with the help of fat grafts or fillers if the patient is not having surgery. As we often see patients for second opinions after they have had surgery, we see this lack of brow fullness frequently. Aging causes decompression of our faces! We recreate the natural fullness. 

2. If one looks at any model’s face, this cheek fullness (NOT overfilled like we see sometimes) gives the face a three-dimensional structure. Just below this malar fullness sits a hollow (3) that is possessed by all attractive faces! Malar fullness (2) and the submalar hollow are a constant in attractive looking faces: by studying and measuring this on many young and youthful faces, we have come up with techqniques that recreate these, even in patients who never had them in the first place! 

3. This is the sub-malar hollow discussed above.

4. The firm and straight jawline follows on from the submalar hollow. We recreate a strong jawline with a strong line and reduce any jowls to reform the yourthful lower face and jawline. This multicontoured anatomy of the midface is not often discussed or analyzed: just pulling tissues creates the dreaded “pulled look” which we often reverse for patients if they are unfortunate enough to come to us with it. It is best to not create this pulled look in the first place. Be aware of the attractive hills and valleys in an attractive face and the loss of these with the passage of time.  


When there is aging of the forehead and brows together with the upper lids and lower lids and cheeks, then the most effective surgical technique is the use of the Hammock Lift. It addresses all of the changes mentioned above and more because you also get an improvement in the jawline and lower face because of our technique. This is a powerful and predictable procedure which Dr. Patel has taught and demostrated in live surgery all over the world. 

The Hammock Lift is now just as popular with our patients as facelifts.  


An examination together with a review of your photographs from years past is the first step. After detailed clinical photographs have been obtained, Dr. Patel sketches the changes and determines the vectors and techniques that are most applicable to you. Not all faces age the same and a bespoke individualized surgical approch gives the best results. 

Please look at our many before-and-after photographs to get an idea of how we approach each face individually.

We also always recycle your tissues: your fat is GOLD and it is never thrown away. We perform fat grafts to reform prominences, mounds and areas of fullness which become decompressed with father time. 


Aging changes of the face cannot (and should not) be divided up like a menu in a restaurant. There is a congruous flow of our bodies and the face and neck in particular. 

Therefore, performing isolated upper blepharoplasty or lower blepharoplasty is reasonable in certain patients but when there is a continuum of changes as seen in the photographs to the right, it is best to address the upper eyelids (upper blepharoplasty), forehead and brow lifts, cheek lifts, with fat grafts and fat reduction from the jowls and the jusicious use of fractionated CO2 lasers to improve pores, fine lines, lip lines and other lines like “pillow lines on the cheeks”. 

Facelift and necklift are usually performed on patients some months later but we have been amazed at the number of patients who get such an incredible improvement even in the lower part of the face and jawline that they are able to delay the need for a facelift and necklift for a long time. 

Please do not hesitate to ask us questions about any other aspects that may bother you. We always remind all our patients: no one NEEDS cosmetic surgery. But if you decide you would like to see an improvement in any aspect of the face, we will pay close and careful attention to ensure only appropriate and safe procedures are performed.

In the presence of a deep groove and ptosis of the cheek, it is unwise to perform just a lower blepharoplasty: your results will be ho-hum! In such instances, a midface elevation with fat transfer combined with a lower blepharoplasty gives the best result. If this applies to your anatomy, it is important to identify the factors before undergoing surgery!

Fat grafts and surface lasers are often used together in Hammock Lifts lifts to give the best results.


This patient presented with concerns of the aging changes on her face. More specifically, she complained of the forehead lines, baggy upper and lower lids, skin wrinkles pores and lines and lip lines. She also did not like the jowls and neck but t she did NOT want a facelift and necklift just yet.

Being a composite approach to the forehead, brows, upper lids, lower lids, cheeks and the texture of the skin, the fullness of the brows and cheeks and the facial lines, one can see the overall improvement we get in this before-and-after split-face image. A secondary and very welcome improvement is in the lower face and jawline although this is not supposed to be a total improvement in the lower face and jawline (for which a lower facelift and necklift are usually performed, when patients want, some months after the Hammock Lift). We also use fat grafts and lasers to give the skin a youthful glow with improved lines, sunspots, etc. 

Most patients will have the face and neck improved in two halves: first the “Hammock Lift” which improves the top two-thirds of the face, followed by a lower facelift and necklift when the patient is ready, usually some months later. There are some patients who will choose to have the lower face, jawline and neck improved first, followed by the Hammock Lift. We would guide you as to what would give you the best improvement. 

A split-face image showing the right side of the face before and the right side of the face flipped on the left after surgery so a direct comparison may be made. The improvement in the lip wrinkles (smoker’s lines) and skin is from the use of fractionated CO2 laser at the same time as the Hammock Lift procedure

Fat grafts and surface lasers are often used together with midface lifts to give the best results. 


"My Hammock Lift is exactly what I needed, but did not know! Dr. Patel explained to me how the Hammock Lift improves the upper two-thirds of the face, including the forehead lines, the brows, the upper and lower lids and the cheeks. I also got an improvement along my jawline which I am thrilled with as I plan on having a lower facelift and necklift later but this has already given me a terrific improvement. I have sent my two sisters to him! Brilliant surgeon: can't speak highly enough about him or his excellent team." ​J. Stevenson "Top Marks" - Park City, UT


A picture tells a thousand words:
The aim is to achieve a congruous balance between the forehead, the upper eyelids, the lower eyelids and the cheeks. A nice benefit of a well-performed cheek lift is the improvement one sees in the lower part of the face. Whilst the midface lift is no substitute for a lower facelift and neck lift, in those patients

that don’t (yet) need a lower facial procedure, it is an excellent “side-benefit”.








Most midface lifts are performed in an operating theatre for the sake of sterility and your comfort.

As midface lifts are often performed in combination with other procedures, most patients receive general anesthesia.

There will be permanent sutures in the temples (these are removed between 2 and 4 weeks after surgery) and dissolving sutures on the outer corner of your lower eyelids: these dissolve in about seven to fourteen days. These dissolving sutures may become itchy as they begin to dissolve and it is fine to gently scratch the incision line.. The prescribed ointment will also help with the itching, as will oral Benadryl (over-the-counter). ​

We use a number of tools, including lasers to give our patients the best possible results. Laser resurfacing, when performed in combination with a cheek lift procedure gives a nice improvement in the skin texture, wrinkles and colour. ​

Most midface lift procedures take 60 to 90 minutes operating time.

Everyone gets bruising and swelling after cheek lifts! Care is taken during surgery to reduce the degree of bruising our patients get. We will also show you how to apply ice to the cheeks after surgery to reduce the swelling and bruising. The worst of the bruising and swelling is over within a week. However, some residual bruising and swelling can take another few days to disappear. Also, the use of the laser leaves the skin rather pink for the first week, after which the pinkness fades slowly. I always remind patients that “it takes us 20, 30, 40 years to age, so a few weeks of proper healing is not surprising.”

Cosmetic surgical procedures are never covered by insurance. ​

There will be a sensation of tightness on the outer corner of the lower eyelids for the first couple of weeks. Numbness and a little stiffness of the lower eyelids and cheeks is also to be expected. The lower eyelids and cheeks will feel somewhat tight for a few weeks: this is to be expected in the immediate postoperative period and does settle. Only moderate pain is experienced by our patients. Most of my patients tell me they just need Tylenol or extra-strength Tylenol after surgery. And even that, just for the first one to two days. ​

Most patients need to sleep with two to three pillows for the first two or three nights. This helps reduce the swelling more quickly. You may be up-and-about  

the very day of the surgery, albeit with some degree of blurry vision because of the healing eyelids. Gentle exercise(brisk walk on a treadmill or gentle cycling) may be resumed within two days. More vigorous exercise like skiing, tennis, etc may be resumed after 10 days. Driving may be difficult for the first two to three days because of blurry vision. Most patients return to work within a week. ​

Bruising, swelling and blurry vision are not risks: they occur in every patient. Some degree of asymmetry is inevitable as this is always the case prior to surgery as well. Some degree of bleeding and oozing of blood-stained fluid for the first few days is also normal.. 

In the first few days, everyone will experience some degree of dryness and blurry vision. You will also feel that your lids look a little tight on the outer corner where you will also feel some of the deeper sutures if you put your finger there: this is of no concern. The tightness and the bumps under the skin settle over a few weeks. 
More serious complications which are very rare include excessive bleeding, and persistent numbness over the cheeks. ​

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