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Cheek Filler or Mid Face Lift?

asked 1 year ago by DeniJ
Latest answer by Michael Law, MD
Question viewed 3,539 times
Tags: age 25-34, jowls, female, comparison, hollowness, options

I am 31 years old. I have extremely hollow flat cheeks, hollow eyes, and now pre jowls and lots of new lines forming and dents on chin. My skin is very much lacking elasticity as it feels loose and no firmness. All of this happenend within 1 year (ever since I turned 30). I believe I have prematurely aged (8 to 10) years sooner than normal as I have been a smoker. I am extremely depressed about these changes. I used to have a heart shape face and now it looks long & flat, pre jowls. Help?

26 answers to Cheek Filler or Mid Face Lift?

+2

Treating your cheeks

The picture is very helpful ! I dont feel that you need a cheek lift at this time. There is not alot of vertical descent of your facial tissues. I feel that you would be very pleases with volume replacement. I tend to use alot of body fat, radiesse and restylane .
Irvin M. Wiesman, MD

Chicago Plastic Surgeon
+2

The Tear Trough Triad: Mid face lift not fillers

The approach to the lower eyelid and cheek (midface) is a very controversial and sometimes intimidating area of the face, and as you can see from most answers the majority of plastic surgeons want to perform fillers in this area which is fine though when looking at your face and your complaint, you have the typical negative vector orbit with a flat midface and early descent of your soft tissue. Fillers are only going to partially correct this, so I would recommend consulting a midface... more
Andrew P. Trussler, MD

Dallas Plastic Surgeon
+2

Cheek Filler, Fat Injections or Midface Lift

Fillers like restylane, juvederm, radiesse or perlane can be very effective in restoring midfacial volume in the cheeks and restoring youthful fullness in a young person who feels they have prematurely aged.   Hyaluronic acid fillers like restylane or juvederm are currently the only safe fillers in the periorbital region but must be done by an experienced injector.  Artful injection is required to create a natural looking eyelid/cheek junction. Alternatively, microfat transfer... more
James C. Marotta, MD

Long Island Facial Plastic Surgeon
+2

Get beautiful cheek bones with fillers!

You are a beautiful woman Deni, even with the slightly flat cheeks! Look at those gorgeous eyes and lips! I think augmenting your cheeks is appropriate, and I would recommend cheek filler injections. Radiesse might work the best, but Perlane or Juvederm  should be just as good, and they are reversible if you don't like the results. If you like the filler results, which you probably will, eventually I would consider cheek implants. They can balance your bone structure beautifully... more
Stella Desyatnikova, MD

Seattle Facial Plastic Surgeon
+2

Use a filler not lift for younger patient

In a younger patient such as you, volume restoration is almost always the first place to start, and a lift is more often appropriate for someone with more skin laxity. You could start with fillers such as Restylane, Radiesse, or Juvederm, but my suggestion would be a fat graft since it will be longer lasting. This could be done under local anesthesia and if done well should look very natural.
Richard Baxter, MD

Seattle Plastic Surgeon
+1

Fat grafting is an option to fill cheeks

First, congratulations on quitting smoking. You are correct that smoking can prematurely age the skin. Structural fat grafting is a powerful tool for correcting one of the primary processes of facial aging: the gradual loss of facial soft tissue volume, which primarily represents the atrophy of facial fatty tissue. The importance of restoring facial fullness cannot be emphasized enough, for without it, very few facial cosmetic surgical procedures are truly rejuvenating. As we age... more
Michael Law, MD

Raleigh-Durham Plastic Surgeon
+1

You have several good options for volume restoration in the face

Don't be too depressed, as you have several good options for facial volumizing and some degree of skin rejuvenation. I would strongly recommend cessation of smoking first to optimize results. Fat transfer can be performed and results may be improved by adding a blood component call Selphyl at the same time. Selphyl uses your own blood platelets to add growth factors to the fat injections. Another alternative is a series of Sculptra injections for volumizing and skin rejuvenation. I... more
Harrison C. Putman III, MD

Peoria Facial Plastic Surgeon
+1

Fillers would be the best thing for you including fat injections

I would most definitely not suggest any midface lift, face lift etc. Cheek implants could help you but I think that they are an inferior choice to fat injections and fillers. Fat injections in the cheek can really rejuvenate your appearance. You have to have enough fat though. Otherwise scultpra is the next option.
Philip Young, MD

Bellevue Facial Plastic Surgeon

www.drphilipyoung.com

+1

Cheek Filler or Mid Face Lift

Thank you for the picture it makes commenting much more personal. I would suggest that you not have surgery at this time and try something non invasive to see if you like the result. I would use Radiesse in your cheeks and believe you would see an excellent elevation of your cheeks and that this would translate into your perception of your face being transformed back to a heart shape. If you like the results you can then have some fat grafting done for a more permanent correction. Of... more
Paul Vitenas, Jr., MD

Houston Plastic Surgeon
+1

Facial Volume Loss

DeniJ- Thanks for the photo...helps a tremendous amount in our analysis of your complaints. I agree with my colleagues in that smoking, although it does not necessarily cause loss of facial volume, very much contributes to aging and loss of skin elasticity and degradation of overall skin quality. Toss the cigarettes today, your heart, lungs and skin will thank you forever! In similar patients as yourself, I have had fantastic results with a volumizing injectable. Sculptra has performe more
John Philip Connors III, MD

Atlanta Plastic Surgeon
+1

Fillers vs facelift

In a young patient like yourself if you want more fullness in your cheeks you may be better off with facial fillers. There are a lot of great products out there and I do not think a facelift will be the appropriate procedure for you at this time.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Shaping the face with fillers has less injury and quicker recovery than mid-face lift

DeniJ, There are three reasons, fillers are the best way to treat your concerns of eye hollows, sagging cheeks, and a loss of your heart-shaped face, is with fillers. 1. Avoid the injury and trauma of surgery. This is big, you avoid 7- 10 days of swelling and the risk of scarring and injury to nerves and the skin. 2. Flexible, adaptable changes. You and your physician can modify your changes together, making them perfect. Once your surgery is done, there... more
David Mabrie, MD

Bay Area Facial Plastic Surgeon
+1

Options for Correcting Mid-Face Deflation/Flatness

Thank you for the photo. I agree with the first step being cessation of smoking.  Whether you decide of fillers or a mid-face lift/implants, smoking will compromise the result. You are young, so longevity is an issue for you.  None of the options available will last forever.  Fillers may last 1-3 years.  The good thing with fillers is the result  is eventually reversible and you can start slow and add more fillers for a customized volume increase.  A... more
Michael A. Jazayeri, MD

Santa Ana Plastic Surgeon
+1

Cheek Fillers or Midface Lift

Smoking will compromise circulation and accelerate the aging process; therefore, the first thing I suggest is to stop smoking. I recommend cheek implants with or without augmentation with fillers or fat from another part of your body. A cheek lift is not necessary.
Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon
+1

Facial aging

Deni: In analyzing your anterior (front) view, I agree that you have lost volume in the midface. Patients usually complain about "circles" under their lower eyelids, the so-called "tear trough", which actually extends obliquely and inferiorly, bisecting the cheek.  What this represents is the appearance of the facial skeleton, as the facial fat pads either thin out, descend or displace.  Before the introduction of hyaluronic acid, poly L-lactic acid, calcium... more
Lavinia Chong, MD

Orange County Plastic Surgeon
+1

You should consult a reputable specialist for non-surgical facial rejuvenation.

I read your concern and reviewed the photo you posted. It's not a good quality photo, but the most striking aspect of your appearance is the look of worry and despair around your eyes. In my view, your cheeks are fine and you have a youthful, attractive heart-shaped face. You may be a candidate for Botox to the area in between your eyebrows. I hope this is helpful for you.
Eric M. Joseph, MD

West Orange Facial Plastic Surgeon
+1

Fillers or Fat are appropriate

As you see from the answers on the board most surgeon favor fillers or fat transfer.  We practice micro fat transfer and harvest the fat in very small clusters this prevents lumpiness from occuring. The fat usually takes well in the upper face but not as well in the lower face and lips where it behaves about like filler.
Richard Gentile, MD

Cleveland Facial Plastic Surgeon
+1

Cheek Filler or Mid Face Lift

Thanks for posting a photo. If you want only one hit or treatment vs multiple sessions or operations. Than I would recommend Stem Cell Enhanced Fat grafts with PRP to the cheeks and areas of the face (at least 15 cc's) + a mini face lift with SMAS. From MIAMI Dr. Darryl J. Blinski 305 598 0091
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

Restoring facial volume

Volume restoration using fillers initially followed by consideration of autologous fat transfers is a reasonable approach to address your concerns.
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Midfacial Aging and Treatments

The situation you describe has a variety of reasonable solutions, some of which you describe. Malar augmentation with fillers is a very safe and satisfying procedure for patients. For significant flattening, 2 syringes of either Juveder Ultra Plus or Radiess is typically required. While only temporary, it has limited downtime and is often the procedure of choice for younger patients like yourself. Cheek implants are another great option to consider. While an endoscopic midface lift... more
Richard W. Westreich, MD

Manhattan Facial Plastic Surgeon
+1

Juvederm Ultra Plus works very well to create fuller cheeks.

Hi. Because you are so young and because you are a smoker, I would start with skillfully done fillers.  They last a year. If not satisfied, I would next  recommend fat injections. Eventually you will be a great candidate for a mid facelift.
George J. Beraka, MD

Manhattan Plastic Surgeon
+1

Premature Facial Aging

You are right, smoking can add 10-15 years to your face. This can be reversed in a number of ways. For the flat central face, the best initial treatment is use of a filler, either something like Radiesse or fat. With more advanced aging, accompanied by changes around the eye, then a lower Blepharoplasty with cheek lift would be ideal. To get rid of the “pre-jowls,” fillers may be effective now. With more changes, only a type of Facelift will correct the problem. I prefer the MACS... more
Robert T. Buchanan, MD

Highlands Plastic Surgeon
+1

Facial Aging

Thanks for posting a pic, it is very helpful in giving advice.  However, it would be helpful if it were higher resolution and had several views.  Based on what I can see, it appears that you could benefit from some procedures.  Fillers would be the least invasive option.  I would recommend Sculptra Aesthetic.  It would take a few treatments, but would give you an overall fuller and smoother appearance.  I would need more views to give you more advice on other... more
David Shafer, MD

New York Plastic Surgeon
+1

Treat volume and skin. Pretty young for facelift

For 31 year olds, I think a facelift is too aggressive and too much surgery.   In addition I think the minimal facelift operation does not address volume or the skin as needed.  For Volume loss (hollow cheeks, etc) I prefer radiesse in the office, or for larger volume, fat grafting.  Hyaluronic acid fillers (juvederm, restylane) also may be needed for areas closer to skin.  For treatment of the skin, I prefer resurfacing.  Fraxel works, as do some peels.... more
Vineet Mehan, MD

Washington DC Plastic Surgeon
+1

Flat cheeks for young women

Looking at your photo, I do see lack of midfacial volume.  You really do not appear to have droopy cheeks. Therefore, I would certainly not recommend a midface lift because it will give you marginal improvments at best. Volume restoration can be achieved with injectable fillers, facial fat grafting or cheek implants. All of these are of value and carry their own sets of pros and cons. If in doubt, start with temporary fillers to see how you like the results before... more
Frank P. Fechner, MD

Worcester Facial Plastic Surgeon
+1

Cheek implants can help hollow and flat cheeks

Hollowness and flat cheeks are best treated with cheek implants placed in the gingival sulcus above the upper teeth through an intraoral incision. The implants are placed in the subperiosteal plane directly over the bone and patients are not able to feel them once they are in normal position. Expect approximately two weeks of bruising and swelling after the procedure.
William Portuese, MD

Seattle Facial Plastic Surgeon

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