Be careful with meddlesome surgery

A cheeklift is not to be taken lightly. Procedures which elevate the midface to the extent that they reduce the nasolabial fold usually are subperiosteal procedures done through the mouth and the temple. They elevate in an upward and lateral direction, increasing the distance between the cheekpads (intermalar distance). This can create a flat artifact. Also hyperelevation of the cheekpads can cause a catlike appearance or bunching to the side of the eyes.

In young patients, filler with hyaluronic acid or more permanent autologous (from the patient's own tissues) fillers should at least be considered first.

Just be careful before undertaking any procedure, especially in the midface. A conservative attitude on the part of the surgeon and great experience in the midface will help the patient to get the best judgment... and result.

Dear Canadaben

As the other doctor's point out, a midface lift is not to be entered into lightly. You do have an issue. The safest way to help the nasolabial fold is with filler. I might also suggest that you have your bite assessed by an orthodontist to see if there is an issue with you occlusion.

However, let me warn you regarding having a midface lift for this particular problem. Midface lifts are done to address a fall in the malar/cheek soft tissues. The is essentially no surgery that will eliminate the nasolabial fold without distortion of the facial features.

However, I think it is worthwhile to ask yourself how many hours a day do you think about this problem? Do you ever feel that other people are aware of your appearance or talk to each other about your appearance or mock your appearance? Do you find yourself afraid to go out in public because of your appearance? Preoccupation with facial features or chronic low self-esteem because of the appearance may reflect a condition referred to as body dysmorphic disorder. Treatment with serotonin reuptake inhibitors(SSRIs) have been helpful for some individuals with this condition. If any of these symptoms strike a chord, you might consider being evaluated by a psychiatrist to determine if you have BDD and might benefit from treatment. This is much better than being destroyed by unnecessary cosmetic surgery.

I have had much experience with midface lift and other facial cosmetic surgery procedures. considering your picture and your age, I suggest a combination of facial fat grafting and midface lift. Of course, you can consider fillers, but it would not last as long, and over time it will cost more than the surgery.