There are moments when your face seems longer than before, the nasolabial folds deepen, or your cheeks feel like they are sagging downward. At times like these, many people hear the expression that the “midface has sagged” and naturally begin looking into the cost of procedures such as midface lift surgery or facelift surgery.
However, not every case of midface sagging necessarily leads to a lifting surgery. In fact, there are also people who worry, “Do I need a lifting surgery?” even though they are still at a stage where surgery may not yet be necessary.
The important thing is to understand the current degree of sagging and its cause. Even with the same midface sagging, some people may need surgery, while others may be able to expect improvement with a relatively simple method.
In this article, we will go step by step through why midface sagging occurs, when lifting surgery is needed, and what options can be considered when surgery is not yet necessary.

Why does midface sagging happen?
The midface refers to the central area of the face extending from below the eyes to the middle of the cheeks. This area is also an important part that affects one’s overall impression.
When we are young, the fat and tissues in the cheeks are positioned higher, giving the face a more three-dimensional appearance. As time passes, skin elasticity decreases, and the ligaments and fascia that support the tissues weaken, causing cheek fat to move downward.
The typical changes that appear in this process are as follows.
✅ Deepening nasolabial folds
✅ A visible boundary between the under-eye area and the cheeks
✅ Downward sagging of cheek fat
✅ A face that looks longer
These changes are not simply a skin issue; they occur as multiple structures such as the skin, fat, ligaments, and fascia are all affected together. That is why the approach can differ depending on the degree of sagging.
In particular, in the late 30s to early 40s, many people feel that their face is not completely sagging, but that the facial line has become less defined than before. At this stage, the tissue elasticity has not yet completely disappeared, so a relatively wide range of methods can be considered.

When is midface lift surgery needed?
Midface lift surgery is a procedure that pulls sagging tissue upward and secures it in place. Because it lifts not only the skin but also the deeper layers of tissue, a clear improvement can be expected in cases of significant sagging.
For example, surgery may be helpful in the following cases.
✅ When cheek fat has descended significantly
✅ When the nasolabial folds are deep and broad
✅ When skin elasticity has greatly decreased
✅ When sagging has progressed across the face as a whole
In such cases, procedures that simply stimulate the skin may make it difficult to achieve the desired change. For that reason, lifting surgery that directly moves the tissue can be one option.
However, because surgery can produce a large effect, it is a treatment that must also take into account recovery time, scarring, cost, and other factors. So rather than deciding based only on cost, it is necessary to thoroughly review whether the method fits the current condition of the face.
In actual consultations, many people are surprised to hear that they are still at a stage where surgery is not yet necessary.
If surgery still feels burdensome, thread lifting is one option
When midface sagging has begun but surgery is still not necessary, thread lifting can be considered.
Thread lifting is a procedure in which medical threads are inserted into the layer beneath the skin to pull sagging tissue upward. The structures on the threads help hold the tissue in place, allowing a lifting effect, and at the same time, they can also stimulate collagen production.
When midface sagging is still relatively early, the following changes are often expected.
✅ Improvement in cheek sagging
✅ Softening of nasolabial folds
✅ Better facial line definition
✅ Overall improvement in elasticity
In addition, because it does not require a large incision compared with surgery, it is often described as being less burdensome.
Of course, the same results do not appear in every case. It is important to make a plan by considering the type of thread, insertion direction, facial structure, and other factors.

Who tends to see better thread lifting results?
Thread lifting tends to be relatively satisfying in the following cases.
The first is when the sagging is not severe. If the cheeks have only slightly started to drop and nasolabial folds are beginning to appear, thread lifting may be enough to expect meaningful change.
The second is when some skin elasticity remains. If the tissue’s own elasticity is still maintained, the threads can support the tissue and allow for a more natural lift.
The third is when facial line refinement is needed. Thread lifting is also used for purposes such as defining the jawline or cheek line.
On the other hand, if sagging has progressed significantly, thread lifting alone may not provide the level of improvement desired. That is why objectively assessing the condition of the face is extremely important.

What matters is not “surgery or procedure”
Among people worried about midface sagging, the most common question is, “Should I get surgery, or is a procedure enough?”
But in reality, rather than simply comparing these two methods, it is more important to find the approach that fits the current condition of the face.
For some people, lifting surgery may be the most effective method, while for others, thread lifting alone may be enough to expect noticeable change.
Also, in some cases, considering laser procedures or other methods together may be helpful.
So when considering treatment for midface sagging, rather than judging based only on cost or a single method, it is necessary to compare multiple treatment options together.

When you start to feel midface sagging, many people naturally think of lifting surgery and begin by looking into the cost.
However, not every case of sagging necessarily leads to surgery. Depending on the degree of sagging and facial structure, there are cases where a relatively simple method can still bring sufficient improvement.
In particular, if you are still at a stage where surgery is not necessary, please remember that you may also consider options such as thread lifting to refine the midface line and help slow the progression of sagging.
| This post was written for informational purposes in compliance with Article 56, Paragraphs 1–15 of the Medical Service Act. All treatments carry a risk of side effects and complications depending on the individual. Before treatment, be sure to have a thorough consultation with experienced medical staff before making a decision. |