Cheek lift Seattle Midface lift - Sam Naficy, MD - Seattle Facial Plastic Surgery Cheek lift, Facelift, Neck lift, Eyelid lift, Brow lift

Naficy Plastic Surgery & Rejuvenation Center

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Dr. Sam Naficy has been awarded the "Patients' Choice Award" by - a website dedicated to rating the quality of physicians across the country. Out of 720,000 physicians, only 5% received this honor.


BOTOX in Seattle

Performed by an experienced facial plastic surgeon, Botox treatments are one of the most effective cosmetic procedures performed in Seattle. This quick and relatively painless procedure can make a real difference in the signs of aging around the eyes. Seattle facial plastic surgeon, Dr. Sam Naficy, is nationally recognized for his experience in advanced techniques of Botox treatment. Read more about Botox


THE FEATHERLIFT FACE LIFT TECHNIQUE - Offered by Seattle Facial Plastic Surgeon

See how you can turn back years in just minutes with this non-surgical facelift procedure (also known as Feather lift, Thread lift, Suspension face lift, or Contour lift). Combined with Botox, Restylane, or fat injections, you can get the younger face you want without the down-time of facial plastic surgery. Read more about the Featherlift procedure......



Seattle, WA - Facelift techniques with minimal recovery.
Healing and recovery time after facial plastic surgery is much less than most people would suspect. The majority of our face lift and neck lift patients need no more than a week before returning to work and social activities, some requiring less than 2-3 days!



By his medical peers in Seattle for his expertise in facial plastic surgery
Seattle Magazine

Cheek and Midface Lift

How does the middle of the face age?

High cheeks are an essential component of an attractive face. With the aging process, the fatty tissue that normally drapes over the cheekbones can begin to sag with gravity. This results in loss of fullness of the cheeks, and a droopy fold of skin and fat between the nose and the cheek (the nasolabial fold). The sagging cheek fat can also alter the appearance of the lower eyelid. For example, bagginess of the lower eyelid often becomes more apparent after the fat of the upper cheek begins to sag. This in essence 'unveils' the bagginess of the lower lids, which have always been there. In addition to sagging of the skin and fat of the midface, there is also volume loss form the cheek with aging, due to loss of cheek fat and muscle. A number of procedures exist to help rejuvenate the aging midface and cheek region. They can be categorized into:

Midface aging is due to both sagging and volume loss from the upper cheek

Early midface aging in a woman of her 40s

Schematic drawing and actual photo of midface aging - Note how the aging in the midface is related to a combination of laxity and volume loss. The tear trough (1) and loss of cheek prominence (2) are direct consequences of this process.

A number of cheek or midface lifting or augmenting procedures may be performed either alone or in combination with other procedures. The goal is to either reposition or replenish the sagging fat of the cheek over the cheekbone in order to restore the youthful fullness of the cheeks. The procedures include suture meloplication or percutaneous cheek lift, endoscopic cheek lift, subperiosteal cheek lift, SOOF lift , feather lift suture suspension, cheek augmentation with implants, cheek fat injection.

Cheek lift

Using minimally invasive techniques with limited incisions, the droopy cheek tissue can be lifted up over the cheekbone restoring the more prominent youthful contour, improving the tear trough and bagginess of the lower lids, and softening the undesirable cheek fold. Incisions are typically hidden inside the mouth, between the gums and the lips, and in the temple. At times, when a lower eyelift is performed at the same time, the same incision may be used to perform a cheek lift.

Before cheek lift, upper and lower blepharoplasty

After cheek lift, upper and lower blepharoplasty
Cheek lift, upper and lower blepharoplasty (eye lift) by Sam Naficy, MD

Subperiosteal midface lift

This is a deep technique of cheek lifting where all the tissue are lifted from the cheekbones and re-suspended in a higher place. Incisions are made inside the mouth and in the temple. It gives the most dramatic and long-lasting improvement, but there is also typically more swelling with this technique.

SOOF lift

The SOOF (sub-orbicularis oculi fat) is an acronym for the fatty tissue of the uppermost part of the cheek, next to the fatty tissue of the lower eyelid. SOOF lift can be performed through the same incisions used for a lower blepharoplasty (lower eye lift) surgery.

Endotine midface suspension

This technique involves use of an absorbable implanted device that aids in maintaining the cheek lift. The device is typically used with the subperiosteal technique of cheek lifting. The device keeps the cheek in the lifted position for a longer period of time, allowing for a better long-term result.

Mini face lift

A mini face lift, or S lift is a technique of lifting the lower cheeks with limited incisions and minimal skin removal. Patients with minimal laxity (typically early to late 40s) may be good candidates for this procedure.


Upper and lower blepharoplasty, S-lift, neck liposuction, lip augmentation, and rhinoplasty by Sam Naficy, MD

Percutaneous cheek lift

This technique is a minimally invasive method of lifting the cheek/midface region. The procedure requires a small incision in the hair of the temple and may be performed in an office setting with local anesthesia or minimal sedation and a rapid recovery period.

Cheek lift photo gallery

You may wish to browse through the gallery of representative before and after cheek and midface lift pictures. Click on any of the thumbnails to enter the slide show. All procedures were performed by Dr. Sam Naficy and some patients may have had more than one surgical procedure performed. The text accompanying the photos describes the details of the procedures performed.

Click on thumbnail to begin viewing slide show.

What procedures may be combined with a cheek lift?

Cheek lift procedures may be safely combined with a number of other facial cosmetic procedures including blepharoplasty, brow lift, face and neck lift, cheek augmentation, lip augmentation, neck liposuction, and laser resurfacing.

What is the recovery like?

Most patients typically experience minimal discomfort and some tightness after the procedure. Discoloration is usually minimal and can vary based on the technique used. Majority of the swelling will generally improve over 5-7 days, but it will take several weeks for all the swelling to resolve. Most individuals will be able to return to work and social activities within 7-10 days although some swelling will still be present.

What type of anesthesia is used?

We use IV sedation anesthesia, which is a very safe and effective method of anesthesia for facial plastic surgery and rhinoplasty. IV sedation anesthesia is extremely safe compared to the standard general anesthesia techniques used today. The main advantages of IV sedation anesthesia are that it does not require putting a breathing tube in the throat, it does not require a breathing machine, the recovery is much faster, there is much less "hang-over" from anesthesia, and there is much less nausea. All these elements translate into greater comfort and safety. Dr. Naficy has used this technique of anesthesia in several thousand plastic surgery procedures without a single anesthetic complication.

During IV sedation anesthesia a small flexible IV (intravenous) needle is placed into one of the veins of the back of the hand. Through this IV line, relaxing medication is given to make you fall sleep. The amount of medication given is adjusted to the specific needs of each person. After you are sleeping, some numbing medicine is also placed in the skin to numb the area that is being operated on. The beauty of IV sedation anesthesia is that during the procedure you are unaware of anything going on and cannot hear anything, yet you are still breathing on your own.

When the procedure is finished, the relaxing medication is discontinued and you begin to wake up. Because the medications used in IV sedation anesthesia clear the system rather quickly, most of our patients are able to go home in less than 30 minutes after the procedure is completed.

Cheek implants

Cheek augmentation can help restore the well-formed cheekbones you used to have when you were young, or if you have never had well-defined cheekbones, cheek implants may give your face the desired contour of higher cheekbones. Cheek implants are made in various shapes and sizes, depending on the area to be augmented. They are typically made out of permanent solid materials that have been used successfully for years.

Before cheek augmentation using implant

After cheek augmentation using implant
Cheek implant by Sam Naficy, MD

The cheek implants are typically inserted through hidden incisions inside the mouth, between the upper lip and the gums. The implant of the proper size and shape is then inserted through these incisions into a pocket created over the bone. After proper healing, the implants typically feel as if they are part of your own cheekbone.

What material is used for cheek implants?

The materials of choice for cheek augmentation are Silastic (medical-grade silicone rubber) and Gore-Tex. Because the implants rest directly on top of bone, they feel as if they were part of the bone itself. These cheek implants are stable over time and do not reabsorb so the results are permanent. As an alternative to cheek implants, fat injections may be used to augment the cheeks, although the fat may disappear over time. A cheek lift may also be used to replace the sagging cheek fat back over the cheekbones.

What is the recovery like?

The cheeks may feel tight, swollen and chewing may be uncomfortable in the days following the surgery. Pain medication is used to lessen discomfort and antibiotics are used. Movement of the mouth and hard chewing should be limited. Stitches in the mouth typically dissolve in approximately 10 days. The majority of the swelling subsides quickly, although the results of the surgery may not be fully visible for as long as three or four months.

What type of anesthesia is used?

For cheek implant surgery, we also use IV sedation anesthesia, described above.

Fat injections

The concept of fat transfer or fat injection relies on the premise that by adding more volume to certain areas of the face, we can improve signs of aging. It is a well-known fact that as we age, the face loses volume of muscle, fat, and bone. For many decades, we thought of aging as an excess of skin. It is now recognized that the apparent excess of skin is at least in part due to the loss of soft tissue bulk from the face, or fat. Fat may be transferred from other parts of the body (usually from the belly, flanks, or thighs) to areas of the face in need of volume enhancement.

What can fat injections achieve?

Fat injections can enhance the volume of the cheeks and can help the appearance of sunken eyelids. The main advantage of fat injection is that it is 100% natural. The other advantage of fat is that there is usually an adequate supply of fat for areas requiring a large volume of augmentation.

Before fat injections to face

After fat injections to face
Fat injections to the cheek and temple by Sam Naficy, MD

Fat injections are also frequently performed around the mouth to enhance the volume of lips and to reverse some of the signs of aging around the mouth.

Fat injection photo gallery

You may wish to browse through the gallery of representative before and after fat injection and fat grafting pictures. Click on any of the thumbnails to enter the slide show. All procedures were performed by Dr. Sam Naficy and some patients may have had more than one surgical procedure performed. The text accompanying the photos describes the details of the procedures performed.

Click on thumbnail to begin viewing slide show.

What type of anesthesia is used?

Fat injections to small areas may be performed in the office under local anesthesia. For larger volumes of fat injection, we use the IV sedation anesthesia technique described above.

What is the recovery like?

Typically, after fat injection, there is minimal discomfort in the donor area (where fat is removed from). Discoloration and swelling of the injected portions of the face area will generally improve over 4-5 days. Patients are usually able to return to work and social activities after one week.

How long will the results last?

Fat injections are longer lasting than most other injectable fillers (such as Collagen, Restylane, Hylaform, and even Radiance/Radiesse). Because fat is a natural substance, there is typically less reaction by the body to the injected fat. The fat does however absorb over time and repeated injections may be necessary to maintain the desired fullness of the treated areas.

Featherlift of Cheek

The "featherlift" is an innovative non-surgical technique that gives a gentle lift to the sagging tissues of the cheek using threads. It has been widely popular in Europe and South America, and rapidly gaining attention in the United States. The featherlift procedure offers quick and relatively painless lifting for patients needing only little to moderate rejuvenation. The featherlift is also known as the APTOS lift, the APTOS thread lift and suture suspension facelift.

  APTOS thread used in featherlift

APTOS thread used for featherlift

The threads used in this procedure are called APTOS threads. These fine threads have small barbs or "cogs" along the length of the thread, much like barbs on a fishhook. These cogs provide lift and contour by forming a permanent support structure for the facial tissue. The cheek or midface region can be typically lifted with 3 threads per side. A full face featherlift would require 18 threads, usually 2 for each brow, 3 for each cheek, 2 for each jaw line and 2 for each side of the neck, although not everyone may need a full lifting procedure. The threads are introduced with a fine needle so the puncture sites heal very quickly, usually without any marks.

Featherlift can improve drooping of brows, cheeks, and jowls

Featherlift threads are placed under the skin in the desired direction of lifting

Who is a good candidate for the Featherlift?

The best candidate for the featherlift technique is someone with early facial aging, with mild loosening or sagging of the facial skin, and not a lot of loose skin. Typically, four facial areas can be addressed, individually or together - the brow, the cheeks, the jowls, and the neck. Individuals with more severe aging changes and sagging could also be candidates as long as their expectations are realistic. The main advantages of the featherlift are that there is typically less downtime than with traditional surgical techniques, there are no incisions, and the procedure is quick and requires only local anesthesia. The featherlift may be combined with other surgical or non-surgical techniques, including chin and neck liposuction, eyelid surgery, lip augmentation, or facial fat injections.

How is the procedure performed?

Most featherlift procedures are performed under local anesthesia (numbing of the skin), however, it is also possible to use IV sedation anesthesia, especially if other procedures are being performed at the same time. The APTOS threads are carefully inserted under the skin using a needle. The placement of the threads depends on the area needing to be lifted. As few as three threads will noticeably lift the cheeks, and two threads will pull back the jowls. The neck and upper brow can also be treated using the featherlift technique. The effect of the treatment will continue to improve over several months as the collagen in the skin collects around the newly placed threads.

The featherlift leaves no significant scars, takes a minimal amount of time (usually just 30 minutes to an hour), and usually only requires ice following treatment. It is a procedure ideally suited towards younger and middle-aged patients, who are not quite ready for a more aggressive surgical procedure. Results are usually achieved with only one treatment.

What is the recovery like?

After the featherlift the patient may return to work as early as the next day, although there may be minimal swelling and there is always a chance of bruising. It is important to avoid excessive facial movement, rubbing, or massaging of the treated areas for the first 2-3 weeks.

What type of anesthesia is used?

The Featherlift procedure may be performed in the office under local anesthesia. For added comfort during the procedure or when the featherlift is performed in combination with other procedures, we offer the IV sedation anesthesia technique described above.


Dr. Naficy is proud to be the first surgeon in the Seattle area offering many of the innovative cheek and midface lifting and enhancing procedures discussed on this website. If you are considering any of these procedures we encourage you to schedule a private consultation with Dr. Naficy in our office. During this visit he will listen to your concerns and discuss your options. He will tell you which technique is the most suitable for you and inform you of its potential risks.

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Naficy Plastic Surgery & Rejuvenation Center     1110 112th Ave NE Suite 150 Bellevue, WA 98004     (425) 450-0880