Blepharoplasty for cheek skin tightening
I'd be very cautious about doing a lower eyelid lift for cheek skin wrinkling. Something about the story doesn't add up. Although you've had several reasons to explain the problem, without a photograph it is all the more complex to discuss your situation. Consider a few consultations with board certified plastic surgeons. You're too young to have someone jump into a blepharoplasty and learn a lesson. I would recomend several opinions in your area. They have great plastic surgeons in Florida.
Cheeklift for tightening skin
A blepharoplasty is a poor choice for tightening lower eyelid skin. It can cause pulling down of the lower eyelid, rounding of the eye, giving it an unnatural, operated appearing shape.
We use short incision cheeklifts (USIC) for this purpose. Cheeklifts can be used to tighten lower eyelid skin with very low risk to the lower eyelid shape.
Blepharoplasty is not effective at tightening cheek skin
Blepharoplasty is very effective at tightening upper and lower eyelid skin, but it is not realistic to expect long-term cheek skin tightening with this procedure. For a minor amount of skin excess, you will be better off with laser skin resurfacing, a chemical peel, or an aggressive skin care regimen which utilzes retinols.
Hope this helps. Best of luck.
Treatment of thin, atrophic skin and Blepharoplasty
I would not recommend a blepharoplasty for you at this time, as it will probably not last and you will, most likely, “sag again anyway.” Skin that is already thin and atrophic will generally stretch again and recreate a problem similar to the original if pulled tight with surgery. There are also increased risks of surgery with skin like this. My recommendation would be to start a Retin-A skin rejuvenation program. This will thicken the dermis (the support layer of the skin and what you lost with the cortisone) and strengthen the skin.
In my opinion, the best is with the Obagi Nu-Derm System which multiplies the effect of the Retin-A. I would also add Obagi’s Elastoderm to also increase the skin’s elastic tissue. This process is slow and will take several years. It is possible that it may correct the problem. However, if, after a couple of years, you still need the skin tightened, there will be less risk of surgical complications or recurrence of the problem.
Blepharoplasty will not tighten cheek skin
A blepharoplasty is not performed to tighten cheek skin. The primary goal for a blepharoplasty is to remove the fat bags on the lower lids and tighten a small amount of eyelid skin. Trying to tighten cheek skin from a blepharoplasty will only pull the eyelids down and give a hound dog appearance.
The cheek will beat the eyelid in that tug-o-war so don't do it!
Removing eyelid skin in an attempt to lift up and smooth out sagging or wrinkled cheek skin is a bad idea. It is more likely to cause lower lid retraction (pull down of the eyelids) than lift up of the cheeks. The cheeks are heavier and will win that tug of war 9 times out of 10!
Blepharoplasty, fine eyelid skin, eye wrinkles
It is difficult to determine what would be best for you without a proper examination. Several factors -- eye condition/dryness, position of the eyelids, eyelid laxity, shape of the cheeks and eyelid hollows, and degree of change you are looking for.
There are several approaches, limited skin excision (pinch bleph), full lower lid rejuvenation with fat transfer and canthal support, fat transfer only, treatment with laser or Thermage.
It really depends here how much skin we are talking about and how much wrinkles there are. It is unrealistic to think it can tighten the entire cheek area. But you can get an improvement for the lower eyelid area.
So it is difficult to tell you what you can achieve without a proper exam, especially with what you are describing.
Blepharoplasty is not good for cheek skin
The problem you are describing sounds like you may have festoons and not excess skin of the lower lid. Festooning is a problem that we see in an older population but, in someone with your medical history of steroid use anything is possible. Attempting to remove or elevate skin of the cheek using blepharoplasty techniques is a dangerous proposition. You will likely not really address the problem and can easily cause further damage to your eyelid.
Blepharoplasty for cheeks
A blepharoplasty is not a solution for loose cheek skin. It is unusual for a 26 year old to have this problem. Certainly, your condition explains some of the reasons.