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Will Cheek Lift Improve Hollow Lower Eyelids ?

I had an aggressive lower blepharoplasty with excessive fat removal. I am now considering a Lower face lift/Neck lift and the surgeon wants to raise the cheeks as part of the lift. I understand this will give me more volume up to the orbital rim, but my hollowness is above the rim.

Given the extra healing time, would I not be better skipping the Cheek lift and treating the lower eyelid with fillers or fat? Thanks

Doctor Answers (10)

Cheek lift to help with hollow lower orbit

+3

I think your surgeon is giving you some good advice.  I think the cheek lift done either using a crows foot incision or the standard facelift incision helps the lower lid quite a bit.  It provides support and improves the "cheek-lid junction".  I do not recomment having a cheek lift through a lower lid incision.  The risk of the lid pulling down is substantial and can be a very difficult problem to treat.  I think fillers are great for an isolated problem but if you are having surgery anyway, a cheeklift is the way to go in my opinion.  Good luck.

Lisa Lynn Sowder, M.D.


Seattle Plastic Surgeon
5.0 out of 5 stars 40 reviews

Cheek lift

+3

I think a cheek lift would be excellent for you if you have jowls that need to be treated or an ectropion.  Otherwise, I would go for fat injection or fillers.

Samer W. Cabbabe, MD, FACS
Saint Louis Plastic Surgeon
3.0 out of 5 stars 2 reviews

Cheek lift never addresses the medial orbital rim

+2

Some cheek lifts will improve the outer half of the orbital rim, but not the innner half. It will also not correct a hollow above the rim.

Fat injection - Viafill is best - will correct these problems. Safe simple and avoids surgery.

Robert M. Freund, MD
New York Plastic Surgeon
4.5 out of 5 stars 18 reviews

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Fat yes

+2

Your surgeon wants to do a midface lift in conjunction with the facelift (which really is a neck lift). For the most part the midface lift involves lifting the tissues off of the bone or periosteum. This creates significant swelling that takes a long time to resolve. It is a great procedure to regain midface fullness and I am a big fan but you are right it will not help your lower lids.

I would recommend lower lid fat grafting. Although this can often take more than one procedure it will correct the problem. The midface lift will not. Fillers are temporary so I would go with fat.

Christopher L. Hess, MD
Fairfax Plastic Surgeon
5.0 out of 5 stars 16 reviews

Mid face lift and the lower eyelids - Los Angeles

+1

I use the cheek lift and mid face lift procedures to raise the lid-cheek junction to improve the lower eyelids.

Raffy Karamanoukian MD FACS

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 46 reviews

Lower eyelid and the midface lift.

+1

A midface or cheek lift is an effective technique when performed alone or in conjunction with other procedures to reduce lower eyelid hollowness.


Several different techniques for midface lifting exist, albeit an eyelid approach will offer maximal improvement of lower eyelid hollowing and smoothing of the eyelid-cheek junction. The eyelid approach can usually be performed through a small incision at the outer corner of the eye. The remainder of the incision is hidden on the inner aspect of the eyelid, unless lower eyelid skin needs to be removed. Sometimes an incision in the mouth at the gum line is used to help re-position the cheek.


Elevation of the cheek will result in upward movement of the underlying fat towards the lower eyelid area. The fat can then be positioned to soften the eyelid cheek junction, and restore fullness of a hollowed lower eyelid. In some instances fat grafting to the lower eyelids is also performed for maximal improvement.


The patient should remember that lower eyelid hollowing can be due to a deficiency of the cheek and orbital bones and not fat. In this instance an implant may be placed underneath the lower eyelid or cheek to improve the hollowed appearance.

 

Adam J. Cohen, MD, FACS
 

Adam J. Cohen, MD
Skokie Oculoplastic Surgeon
3.5 out of 5 stars 12 reviews

Cheek lift for hollow lower eyelids

+1

Although a cheek lift will improve the hollows of the lower eyelid, don't do this procedure unless you have ptosis (sagging) of  the cheeks. Injection of fillers or your own fat is a much easier technique to augment those depressions.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Yes, in the outer half of the lower lids.

+1

Hi!

In Manhattan, we think the mid facelift is a great operation. One of the things it accomplishes is correction of hollowness, but not so well on the inside (towards the nose). Of course it is hard to be sure without seeing you, but for you, well performed fat injections may be best. Much depends on how they are done. Skip fillers.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Maybe fillers would be better

+1

It is really hard to address this question without pictures. If you have already had an "aggressive" blepharoplasty, I would recommend using fillers in this area and skip the cheek lift. However, if your surgeon (the only one who has examined you) can explain his/her understanding of your situation and sees a cheek lift as a possible solution, then that might be worth a consideration, but I would still lean toward fillers. Good luck.

Sirish Maddali, MD
Portland Plastic Surgeon

Excellent question!

+1

This question shows you are thinking well. Unless you have very loose cheek skin, this will not work. Furthermore you take the chance of pulling the eyelid down, unless the surgeon has a great deal of experience in doing this operation. Without seeing this my best guess is fillers or fat would be best--fillers are temporary--fat injection also takes an experienced surgeon so you don't end up with "sausages" in you lower lid.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.