I would like to correct my flat drooping cheeks. I have extra skin and some fat in my cheeks and chin that becomes much more pronounced when I smile and my nose tip droops. My under eye whites are visible and my mouth is slightly down-turned. I like the way I look when I pinch and lift my cheeks.
What is the Best Procedure for a Drooping Lower Face with a Strong, Full Jaw and Chin?
Doctor Answers (10)
Drooping lower face and strong jaw
Based on your photos and the result you are trying to acheive I would recommend two options. The first would be a fat transfer which would volumize your cheeks giving a more pronounced enhancement of your cheek subunit. It also would act to artificially lift at the nasolabial fold region and midface giving you a taller more elegant cheek bone appearance. If the droop in your nose on smile is bothersome a simple procedure to separate the muscle known as the depressor septi would improve this problem and decrease the nasal droop. This can be done through a tiny incision on the inside of the nose. Standard lifting procedures would be a complete waste of your time and energy at this point in your life as you are quite young and attractive and those porcedures would not give you the desired result. Hope that helps!
I agree with all of my fellow responders. They have all suggested different appropriate treatments. I suggest you have several consultations to clarify your goals and decide which approaches will satisfy your personal desires.
Surgical versus non-surgical face lift and nose job options
From your pictures, it is difficult to recommend a face lift for a person with your relatively minimal facial laxity. However, your concerns could be addressed with facial fillers. This would require repetition on a yearly basis or so but could delay surgery. Alternatively a longer term solution could involvem the use of a short scar face lift with fat injections. Lastly I do not see the drooping nasal tip you describe with smiling. Have you had a previous rhinoplasty? A tip rhinoplasty and even the use of Botox could minimize tip drooping with smiling.
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Perhaps you do not need a lift at all?
Looking closely at your pictures it appears that you have a lot of pigmentary issues and post-acne facial atrophy.
We treat this now with a combination of restoration of volumn (usually Sculptra or Radiesse) combined with Mixto Laser which both shrinks to skin to the new foundation and does a great job of evening out skin color. (In Florida we have done this on many patients who have Hispanic dark skin.
It is totally non-invasive, less expensive, and done without anesthesia. The Mixto and fill are done at the same session. Additional fill may be needed later depending on your response to the filler and shrink together.
Cheek lift in younger person
You are the person for whom the MACS Lift, a short scar facelift was developed. There are many Plastic Surgeons in your area or nearby doing this.
Droopy Lower face and Droopy Cheeks
You may have many options including fillers and small surgical procedures. A mini jowl and neck lift can tighten your jowl and neck area. You may also be a candidate for a mid-face lift and/or a cheek augmentation. Fillers to enhance your cheek area would include Radiesse or Silicone 1000. Difficult to say without examining your face.
Drooping Lower Face or Loss of Facial Volume?
I agree with Dr. Pearlman's statement that your aging changes relate more to volume. Based on the photos shown, I would recommend that you consider Sculptra (poly-L-Lactic acid) injections in a sequential fashion (spaced every 6 weeks) for gradual addition of facial volume in the mid-face, temple and pre-jowl regions. Many Surgeons (including me) had been very critical of Sculptra in the past. However, the newest guidelines for injection, which call for deeper volume replacement help avoid many of the problems previously seen with this product.
I am sorry but I think you will ultimately regret having a facelift at this point
The point is we live in a world where if you knock on enough doors someone will operate on you no questions asked. G*d knows maintaining the place in the Hamptons is expensive. A facelift will tighten your face but that is not what you need. By the way, stop pulling on your face that way or you will need a facelift. I am not certain without examining you what you need. I am impressed with how wonderful your neck line is. What you appear to need is some skin care and appropriately done facial fillers. For this, I recommend that you find a cosmetic dermatologist with a reputation for being honest and conservative. I know that sounds like a contradiction but that is the crazy world we live it.
If you still feel you need surgery, I encourage you to ask yourself if you have some deep seated need to punish yourself. Occasionally I encounter people with a history of emotional or sexual abuse as children or young adults who seem to be attempting to master their trauma by having surgeons recreate another trauma. Does this apply to you? Don't know but I will tell you that is great to have wonderful cosmetic results without the need for surgery. This should be your goal. If you feel compelled to seek out something else, please stop to ask yourself why. Consider reading my blogs on why we get cosmetic surgery.
Photos help but nothing substitues for a personal exam when it comes to facial rejuvenation
You posted photos of your face demonstrating a desire for a lift of both your cheeks and nose. Facelift and minimal tip rhinoplasty may be the appropriate options. However, with facial fillers, I am often getting great results that can put off facial rejuvenation surgery. It is more a matter of facial volume loss as part of aging instead of gravity changes.