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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 12

Cheek lift to help with hollow lower orbit

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 57 reviews

Cheek lift

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
4.5 out of 5 stars 22 reviews

Cheek lift never addresses the medial orbital rim

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
5.0 out of 5 stars 26 reviews

Fat yes

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.

Will Cheek Lift Improve Hollow Lower Eyelids ?

Thank you for your question. You have a very specific concern which would be best addressed during an in-person consultation with an experienced facial surgeon. In general, the mid-face region roughly correlates with the area between the lower eyelid and the corner of the mouth. A mid-face lift, sometimes referred to as a cheek lift, can help to restore fullness to the midface by vertically repositioning the soft tissue of the cheek to a higher, more youthful position on the cheek bone. At the same time, lower eyelid appearance is often improved as the repositioned cheek tissue is more favorably redraped over the lower orbital rim, minimizing the unfavorable hollow appearance of the lower eye region. In some cases, the hollow appearance above the lower orbital rim may be improved as the rim itself is revolumized with the vertically repositioned cheek. Revolumization of the orbit itself (above the lower orbital rim) with either fillers or fat is not commonly attempted due to the associated risks. Warm regards.

James M. Pearson, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 64 reviews

Cheek Lift can help fill in lower lid hollowing

A cheek lift through the eyes is a good and current technique in the right hands and can help fill in the hollowing from the over resected fat from your blepharoplasty as can fat transfer or fillers. You will need to find a great plastic surgeon for this. -  (see link).

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 76 reviews

Mid face lift and the lower eyelids - Los Angeles

I use the cheek lift and mid face lift procedures to raise the lid-cheek junction to improve the lower eyelids. Stimulatory fillers can also improve the results of your midface lift.

Raffy Karamanoukian MD FACS

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 70 reviews

Lower eyelid and the midface lift.

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 13 reviews

Cheek lift for hollow lower eyelids

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 23 reviews

Yes, in the outer half of the lower lids.


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

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.