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Michael Kulick, MD answers: Facelift disproportionately fat face?

I have what I'd consider a very disproportionately fat face. I'm only 33 and thin yet the corners of my mouth are always turned down along with "marionette" lines.

And my lower face is heavy. I have the puffy swollen cheek look of someone who just had dental surgery. When I pull the lower cheek skin back toward my ear it looks so much better.

I know it's impossible to know for certain without a picture, but am I describing something that requires a Facelift to fix?

Michael Kulick, MD
8 months ago

Although anything is possible, a true Facelift is something that is rarely needed for someone your age. Having said that, I preformed a "re-do" on a woman that was in her mid 30's! The problem for her was that she received a SMAS lift and without having the dissection expend to the corners of the nose and mouth, the pull on the skin did not provide her a lasting result. One year after her SMAS Facelift, I performed a laser vertical Facelift.

One option to consider are skin fillers. Some are more lasting than others but that can help fill out the lines you described. It depends on how prominent the lines / sagging is.

For the fullness of the cheeks, you can have the buccal fat reduced. However, this can come back to haunt you years latter as a fullness of the cheeks can be considered "youthful."

The best thing to do is seek consultation with a few certified Plastic Surgeons that understand what I have discussed.

Hope this helps.

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