You shouldn't have any more fillers. Being "overstuffed" is not desirable. You don't have enough mid face laxity from your photos to indicate a mid-facelift. Modest tightening from Thermage would probably be a good choice. Get a consult from a board-certified Facial Plastic surgeon. Best wishes.
Lift, fill, or tighten
I think you currently have great facial structure. You don't need to fill anymore or you'll risk doing too much.
Your lid-cheek junction appears well blended and you don't show many signs of facial descent so it also may be early for a mid face lift.
Ultherapy may be helpful but an exam is needed to assess the laxity of your skin.
What at I think you would clearly benefit from would be a resurfacing of your skin with either a laser or deep peel. Not only will it tighten your skin, but also improve and rejuvinate your complexion to eliminate some of the irregulaties you see.
An in person consultation is important to better define your goals and what is right for you.
I notice the puffiness in your cheeks in the first two photos. Is that what you are trying to correct or had that been caused by the fillers. I don't think more fillers are the answer to you and thermage doesn't work. You could possibly benefit from having your lower lids lifted or a mid face lift which accomplishes the same thing, but no more fillers.
Looking at your photos I think you are an excellent candidate fot Allergans new "Voluma" preparation that is injected over the malar bone area and enhances the midface nicely and naturally. The new Voluma is advertised to last 1-2 years making its application cost effective and worthwhile. I have used it on dozens of patients very successfully in the past 9 months. You certainly do not need any surgical work yet (lifting). If you want a permanent enhancement of the midface you might consider cheek implants ...this is an excellent procedure that also is done under local anesthesia and takes less than an hour.. If you choose the right size cheek implants and they are placed correctly they look 100% natural and last a lifetime.
More fillers for mid face?
Thank you for your question about fillers for your face.
- You do not need and should not have more facial fillers.
- Your 'worse' look appears to be in overhead lighting, possibly fluorescent. People always look poor with this kind of lighting.
- If your skin is loose, consider no-down-time treatments such as ND Yag laser, Ultherapy, etc.
- If your skin quality is poor, consider topical prescription strength skin creams that include tretinoin.
- And to deal with poor lighting, see a make-up consultant as to how to lighten the areas where shadows form. Best wishes.
The best recommendation is to have an in-person consultation with a board certified specialist in the face. 3-dimensional computer imaging can help you visualize the issues you are seeing and how you might look after some enhancements. More importantly, it will serve as an important communication tool with your doctor.
There are loads of excellent plastic surgeons in LA. Go on some consults thereand get some recommendations after an in person examination to better evaluate your face
Early fcial aging
The patient has early facial aging in a very long face. She has had "permanent" filler placed in the past. Although I have strong feelings against "permanent" fillers I think she would do well with Voluma to augment the upper cheeks. It does not appear that the patient is ready for a facelift or mini lift.
Volume loss of cheeks.
Volume loss of cheeks for u is either Voluma which lasts for 2 years or a small cheek implant. See an experienced surgeon. Ultra therapy or mid face lift is not for your problem.
Is a midface lift, ultherapy or more fillers are the best course of action to address that area and not look "done"?
The options to improve the cosmetic appearance include
surgical procedures, non-surgical treatments, or a combination of both. The
optimal approach would depend on your anatomy, physically feeling the tissue,
assessing your desired outcome, taking a full medical history, and discussing
the pros and cons of each operative procedure. Anyone on this or any other website that would tell you exactly what to do making a determination of the most optimal option or options from just a brief history and looking at limited photos would not be in your best interest.
I would suggest that you have consultation
with a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American
Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with.
You should discuss your concerns and options with that surgeon in person.
La Jolla, California