At 33 years old, I am noticing some negative changes in my mid face, where I am starting to develop nasolabial folds. I'm not really sure if I should get injections or a mid face lift, or both to fix the problem in my cheeks. I don't mind taking a few weeks off to recover from the mid face lift, and would much rather do it once and get it over with, since I hear the fillers can be extremely high maintenance and usually have to be repeated every 6-7months.
Mid Face Lift to Address Cheek Issue?
Doctor Answers (14)
Mid-Face Cheek Lift Challenges
The challenges of facial aging remain that we have loss of central facial fat compartments as well as skin sagging causing jowl atrophy. In general, in a patient that has volume loss without skin sagging I would recommend facial fillers to restore malar contour and shape. As one ages, I would usually recommend a true “Lift & Fill” facelift versus a mid-facelift done through the eyelid and cheek area. The “mid-facelift” has significant morbidity and complications in contrast to a “Lift & Fill” type of SMAS facelift, which does rejuvenate the mid and lower face area by filling the depleted fat compartments of the face using your own fat and lift using SMAS to restore your youthful appearance.
Optimal choice for early aging of the face
Based on your photos you do not need any surgical procedures at this time. I perform mid-face lift in a younger population routinely, but only if the facial anatomy calls for it. In your case judicious use of longer lasting fillers will correct some of the contour issues of your face, like Nasolabial folds, prominent muscle bulges at the corners of your mouth, etc.
The field of facial surgery is full of gimmicks and sub-par procedures. A face lift is not one specific procedure. An experienced and expert facial rejuvenation surgeon will carefully assess each patients individual anatomy and aging process to design a unique surgical approach. Only in this fashion can a beautiful, dramatic, natural and lasting result can be obtained.
Make sure your surgeon carefully explains to you what procedure is being contemplated and what is the expected result. Only then can you avoid disappointment after surgery. You might find it insightful to ready a few articles on face lifts, which can be found on my web site under "publications".
Midfacelift to address cheek issues
The part about the fillers needing to be repeated every 8 to 12 months is in fact true. However, midfacelifts, while they can create a significant improvement in midfacial fullness (elevating up the midcheek fat pad) and jowls, the improvement in the nasolabial folds is not always as much as desired, so sometimes these need to be filled anyway.
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Midface volume loss
Reviewing your photos, suggest the opposite, you have planty of midface volume. I agree that a lift won't help with your nasolabial folds. Filling them is your best choice.
Keep in mind that even children have nasolabial folds. But as we age, we assign blame for the aging process on these folds. They are not all bad.
Mid facelift will not fix nasal labial folds
A mid facelift will not fix nasal labial folds. Nasal labial folds are best treated with either fascia grafts as a standalone surgical procedure, or filler such as Restylane and Perlane.
Do Fillers or Fat
You are too young to have a midface lift. And as much as I want the midface lift to fix the nasolabial folds it won't do as much as you think. It's more for restoring the cheek fullness rather than correcting the folds.
Filler are really designed for this problem but you are right in that they're not permanent. Fat can also be a good alternative. It can be permanent but it is highly unpredictable and therefore may need to be repeated.
Fill your midface and nasolabial's
Based on your photo, I would not suggets a midfacelift. It seems as though you have some slight midface volume lose, you do not look like a candidate to raise the midface, by filling it it will advance 3-dimensionally and give the appearance of a lift if done correctly. I would recommend starting with filers, then if you like the results you could get fat transfer. You are years away from needing to lift the midface.
Midface Lift with Facial Fat Grafting
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.
Be careful what you wish for.
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.
Fillers would be a good option at this point
Losing volume in your face can lead to the nasolabial folds becoming more prominent.
- A midface lift is not a favorite procedure of mine. I think it shifts tissue upwards but it doesn't address the nasolabial folds significantly.
- The reason for this is because I think that the folds are really due to a significant volume loss in the cheek and lower eyelid region and bringing more youth back entails adding volume back to these areas.
- Fillers are a great way to do this. But they are temporary. A more permanent filler would be fat injections to the area around the mouth and in the cheek. This can be done without incisions and all that is needed are small puncture holes that heal essentially imperceptibly.
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.
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