The aging midface is caused by a complex process of soft tissue volume loss, gravitational changes, and attenuation of the ligaments involved. This process results in a skeletonized appearance and elongation of the eyelid cheek complex and a medial and inferior descent of the malar fat pads. Standard facelifting techniques have been unsuccessful in addressing these issues. The authors describe the technical aspects of the closed meloplication percutaneous cable suture technique in detail, evaluate 55 cases as a retrospective chart review over a 5-year period, and address the complication rate.