This is as a result of loss of cheek fat-pad volume and laxity of the lower eyelid and mid-face skin. As a result tear trough and lines either side of the nostril (naso-labial line) settles in. To correct this a mid-face lift with or without increasing the volume of cheek fat-pad is performed. Mid-face lift is best performed through lower eyelid approach by means of slinging cheek fat-pad to its original position to the orbital rim (the higher portion of cheek bones). To volumise the cheek Colman fat injection or dermofat graft can be added to the procedure. To improve the results of lower eyelid reduction mid face lift is commonly used simultaneously.