Skip to main content
Endoscopic Midface Lift city, state

young woman As the face ages, the effects of a constant force of gravity are coupled with changes in the skin and connective tissue, as well as a loss of fat (adipose tissue). The earliest changes occur in the area around the eyes (periorbital region) and the midface (the part of the face between the eyes and the mouth). The youthful convexity (fullness, or round appearance) of the midface decreases as the malar fat pad descends. This has two major effects: first, and most obvious in younger patients, is the appearance of tired, hollow, or sunken eyes; second, and often a little later, is the development of visible nasolabial folds – even at rest. The most distressing part of these changes is that patients do not feel as old as they look – they have great energy and passion, but are often asked if they’re tired or not getting enough rest. Shadows around the eyes, or a subtle shift in the weight of the face from the upper cheeks to the lower face, are visual signs of age. And the unfortunate truth is that we live in an “age-ist” society.

Dr. Ransom can address these specific concerns with a variety of techniques, and is proud to be the one of a select few surgeons in the Bay Area offering a minimally-invasive endoscopic facelift (also known as the extended centrolateral, transtemporal midface lift). Rhytidectomy, also known as “facelift” or “face-lift” is a surgical procedure designed to release and reposition the soft tissues of the face, and, in many cases, to remove excess skin and fat. With a minimally-invasive midface lift, all of the incisions are placed behind the hairline – so that they leave no visible scars! Dr. Ransom uses these hidden access points to lift the soft tissues of the midface, returning them to a more youthful position and giving a natural-appearing rejuvenation.

Who is a candidate?

Candidates for a midface lift (endoscopic facelift) include all patients with a drooping or hollow-appearing midface, and the early signs of jowls and loose or sagging skin in the lower face. The term facelift (or face-lift) can be used by doctors and in the media to imply a wide variety of procedures and approaches. Dr. Ransom uses the midface lift (endoscopic facelift) for select candidates with primary aesthetic concerns in the middle and upper thirds of the face. This approach is minimally-invasive, using small incisions placed behind the hairline. As such, it is not appropriate for patients with significant skin excess or heavy neck tissues. These patients are better served with a mini-facelift or facelift. As a final note, the midface lift using a predominantly vertical vector, which helps Dr. Ransom’s patients look natural, avoiding the “wind-swept” or “pulled” look.

Frequently Asked Questions

Question: How long is the “down-time” after a midface (endoscopic facelift)?
Answer: For most patients, a week off of work is sufficient. Bruising and swelling will occur immediately after the surgery, and begin to resolve around the third day. The majority of this process occurs in the first week. Pain is very minimal. Dr. Ransom works closely with you throughout the postoperative period, making sure that you are making progress toward an excellent result. Further details can be discussed with Dr. Ransom during your confidential consultation.
Question: If I am a smoker, can I still have a midface lift (endoscopic facelift)?
Answer: Yes. Though Dr. Ransom would strongly advise you to quit smoking to improve your overall health, smokers can undergo endoscopic facelifts. With the endoscopic technique, the plane of surgical dissection is deep to the blood supply of the facial soft tissues. As such, problems with blood flow that are associated with tobacco use are avoided. This is because the blood supply to the face is preserved in this approach, and better blood supply means better healing. As a side note, Dr. Ransom has a keen interest in helping patients try to quit smoking (tobacco cessation), and has even performed clinical research in this area. He would be happy to discuss this with you during your consultation, and he is able to prescribe medications to help you quit before surgery.

Please note that all patients are different and individual healing times and results may vary. The statements regarding procedures and recovery made here are general rules.

Our Patient Reviews

San Francisco Center for Facial Plastic, Reconstructive & Laser Surgery

5 / 5.0

Based on 23 reviews

Christina G.

I had several nasal/sinus issues including a severely deviated septum and a dorsal hump, which I wasn't crazy about. Dr Ransom did both the medical and aesthetic parts of my surgery and he did a wonderful job! While I did have some swelling, I didn't experience much bruising at all. I loved that he left the natural look of my nose just making small corrections. My breathing has GREATLY improved. His office staff was super helpful in scheduling and making sure payment and everything was very clear. I am very, very, very pleased with my results!!

Tk I.

I had a terrible surf accident in Bali and needed to get 50 stitches to repair what the reef did to my face. I had emergency cosmetic surgery in Bali the day of the accident. Immediately when i got back to the states i was introduced to Dr Ransom through some mutual friends. I was searching for the best cosmetic surgeon in San Francisco to help in my recovery. He and his team have been amazing! he helped establish a plan for my post-op wound care/treatment and administered some initial laser treatments. Dr Ransom and his team are extremely knowledgeable and very patient / helpful. I am very grateful for their help and support. I am finally looking normal again!

Joey B.

I had three issues with my nose - which inhibited my breathing: 1- broken nose, 2 - narrow nostrils that collapsed when I inhaled through my nose, 3 - deviated septum. When I was living in New York, I went to see a doctor about my breathing issues, and he said my skin was too thin and there was likely nothing he could do to rectify the problem. Dr. Ransom was recommended by an ENT I saw through One Medical. As soon as he saw him, he said he could easily fix my nose, and remove the bump that had formed from the trauma. His confidence and strong sense of self immediately put me at ease, and I had little doubt that he could accomplish exactly what he promised. He showed me a modified picture of my nose , and really liked what he proposed. The end result very closely matched what he promised. Not only can I now breath much more easily through my nose, it looks much better. He managed to make it look like an improved version of itself, however I still look like me, and unless I tell anyone I had it done, it's not overly noticeable, which I prefer. I'm pretty vain and very critical, and I can say that Dr. Ransom is great, and comes highly recommended.

Edward T.

Doctor Evan Ransom took my surgery on relatively short order and did a wonderful job. He is very talented and has a nice friendly professional support staff. I can not thank him enough, he was calm, caring, professional and interested in the follow results of his work . He seemed to bring a certain artistry to the profession.

Lisa C.

Dr. Ransom is a talented physician. He is knowledgeable, professional and goes the extra mile to make you feel comfortable during your treatments. He has been blessed with an artistic eye which brings wonderful results. I highly recommend Dr. Ransom and would refer all of my friends and family members to choose him as their physician.

Cheryl H.

Dr Ransom is very kind, honest, and conscience doctor. I was referred by my best friend, she is also Doctor Ransom patient. She has so much good things said about Doctor Ransom. So I had a face lift done by Doctor Ransom on July 2015. He did a wonderful job on my face and I have a lot of compliments on my face. So if anyone want to get their face done. I would highly recommended Doctor Ransom to you. I give Doctor Ransom a five stars.

Jill P.

I have currently been getting botox regularly with Dr. Ransom and he does a fantastic job. My previous doctor's office moved to another location where it was no longer convenient. I didn't realize what I was missing until I went to Dr. Ransom. I felt really comfortable, but most important he did a terrific job blowing my previous doctor out of the park. (Sometimes it's good switch it up a bit to make sure you are getting the best treatment.) On top of that, Dee the office manager is an incredible asset to the office. She personalizes your visit and relationship with the office to an extent I have never experienced before. I even get follow up calls to see how I am doing after a treatment. I highly recommend Dr. Ransom for his great work, and his team's impeccable customer service.

Arielle C.

Dr. Ransom and Dee are the BEST! Whether it's aesthetic or reconstructive, I'd trust him over and over again with my face.