Sunken cheeks - how to make face more youthful after weight loss? (Photo)

Question

I'm 59 years old, in very good health, weigh 60 kg now, having lost 14 kg with a healthy diet and exercise routine (which I will continue to follow). As expected, this weight loss also resulted in sunken cheeks that also emphasize my deep nasiolabial folds. What are the options to make my face look more youthful? (I previously had a brow and neck lift, both procedures produced good results).

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question and pictures.  
You would be a good candidate for Concept Facelift.  After the Concept Facelift you could add some volume using dermal filler such a Voluma.  When people age and weight loss will mean tissue and skin elasticity is lost.  These can be repositioned by a facelift.  You also loss volume which can be put back using fat transfer or fillers.  The fillers are a good temporary solution however they do last about 18 months. 
I perform under a local anaesthetic which means a significantly reduced downtime.
Most of my patients want a facelift however do not want the downtime associated.  The Concept Facelift is the procedure I perform, which combines the latest surgical techniques with the use of local anaesthetic to dramatically reduce the risks associated with traditional facelifts, while significantly reducing the bruising and downtime of your recovery, from months to a matter of days. 
If you have lax facial skin, lost volume and feel that you have jowls and wrinkles on your cheeks and you look tired when you're not then the concept facelift can help improve your appearance. With concept facelift you will look natural and fresh just like the way you feel inside. The Liposuction helps create a defined and L shaped neck.  There are no bandages, drains and hospital stay but with lasting results of traditional facelift techniques it fits with today's age.
 Typically recovery period is 7-10 days as you do tend to bruise more with your eyes than facelift and necklift.  You would need to return for a follow up appointment 7 days later to check your healing progress.  This can be combined with lower eyelid surgery which I think will give you a fresher appearance.
What are the benefits of a local anaesthetic facelift?
Minimally invasive as it is a short scar facelift, although has the same effects as the Traditional Facelift as the SMAS muscle is tightened along with the skin.There is minimal bruising and swelling, especially when compared to traditional faceliftsAs the procedure is performed under local anaesthetic, you can go straight home following the procedureFull recovery in a matter of days rather than monthsSignificantly less risk than Facelifts performed under general anaestheticFresh, youthful and long lasting resultsPlease make sure you find a reputable and qualified plastic surgeon

Jason Emer, MD · Answer

Facial sculpting and contouring can be created with well-placed fillers (Voluma, Countour, Radiesse, Bellafill) and Sculptra, which would give improvement in facial balance. Fat or implants are alternatives. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Jed H. Horowitz, MD, FACS · Answer

Hello simonCheek implants are used to increase the projection of the cheekbones. They increase the fullness of areas of the cheek that may be receded or flat. Cheek implants add body and contour to cheeks that lack definition. Fillers such as Juvederm Voluma, Radiesse and RestylaneLyft are great alternatives to cheek implants, also fat transfer or injection can be done.

Stephen M. Davis, MD, FACS · Answer

Thanks for writing,As we age two things happen. 1) we loose fat in our face, 2) our skin is sliding of our face. You could use vertical repositioning of your fallen fat, plus or minus fat grafting and horizontal repositioning of your jowl / neck skin and fat, MACS lift which is powerful lift. Good luck Stephen M. Davis, MD, FASCCertified: American Board of Plastic SurgeryMember: American Society for Aesthetic Plastic SurgeryMember: American Society of Plastic Surgery

Joshua A. Halpern, MD, PA · Answer

You may be a candidate for a cheeklift with fat injections. As one grows older, even without weight loss, it’s not uncommon to loose fat in the cheeks. As a former art student from the LA county museum of art, when I would pain a young person I would highlight and emphasize full cheeks. When painting an older person, one would depict a person with shallow or sunk in cheeks. Fat is harvested from one part of your body and injected into the cheek area. I utilize Dr S. Coleman’s technique. This tends to give a natural youthful long lasting result to the face. I hope you find this information useful. Please watch the enclosed video.

Julie Edween, DO · Answer

Simon43,Congratulations on your recent weight loss!  Restoring the youthful volume contours after significant weight loss can be achieved by a combination of a facelift in combination with targeted fat injections to the areas that have lost volume such as your mid face/cheek area as well as nasolabial folds. Best of luck!Dr. Julie EdweenFacial Plastic Surgeon

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts.  From the photos the weight loss has reduced the mid face and lower face fat resulting in concave portions of the mid face, excess sagging skin, jowls and weak mandibular angles.  These combine to create a very thin, elongated, rectangularly-shaped face.
 Following my beauty principles, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.  The hollows in the mid and lower face can be filled in with Sculptra.
 "Jowls” are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
 My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
proper SMAS Imbrication technique
no incisions within the hair = no hair loss
excess fat can be removed from the face and neck
excess skin removed from the face and neck
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
 I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.
Hope this helps.

Sunken cheeks - how to make face more youthful after weight loss? (Photo)

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