Would a lip lift revision and cheek implants help me achieve a more balanced look? (photos)

Question

I’ll be 45 this year and think I have pretty amazing skin. A few things bugging me: mid face volume, my right side is jowlier/droopier than the left. And my lift lift I had 7 years ago looks like it needs to be redone. Big thing to know is I have/had Graves’ Disease and have been in remission for over a year. Am I a candidate for another lift lift and maybe cheek implants? Not a fan of fillers after Graves’ ate them away overnight when it was active.

Anna Chacon, MD, FAAD · Answer

At 45, having good skin quality is definitely an advantage when considering facial surgery. From what you’re describing, I can understand why you’re thinking about a more structural approach rather than continuing with fillers—especially after your experience with fillers during active Graves’ disease.

A revision lip lift can be considered if the previous lift has stretched, the scar has changed, or the current lip-to-nose proportions no longer give you the result you originally liked. The fact that your first procedure was seven years ago does not automatically prevent you from having a revision. The important questions are how much tissue was removed previously, where the scar sits, how much additional shortening is actually possible, and whether the issue is truly the lip lift itself or changes in the surrounding facial tissues over time.

For the midface, cheek implants are a very different approach from filler. They provide a permanent structural increase in cheek projection and can be useful when the cheek area is relatively flat or has lost some volume. They can also help create better facial proportions without relying on injectable volume. However, implants are not simply a replacement for filler—they primarily add projection to the cheekbone, so implant size and position have to be chosen carefully to avoid looking overly prominent or artificial. Asymmetry is also important to consider because the two sides of the face are rarely identical, and cheek implants can sometimes require revision if they shift or don't produce the desired contour.

Your right-sided jowling or drooping is the part I would evaluate separately. Cheek augmentation may improve the transition from the midface into the lower face, but it will not necessarily correct true jowling. If there is actual descent of the cheek and lower facial tissues, a lifting procedure or another form of soft-tissue repositioning may have a greater effect than simply adding volume. Facial balancing is really about determining whether the imbalance comes from volume loss, tissue descent, bone structure, or a combination of those things.

Your history of Graves’ disease is especially important. Being in remission for more than a year is reassuring, but I would still want your thyroid function to be stable before elective surgery. Graves’ disease can also involve the tissues around the eyes, even when thyroid hormone levels are controlled, so any history of thyroid eye disease, eye bulging, double vision, dryness, or other eye symptoms would be relevant to the surgical planning.

So, in principle, yes—someone with your history can potentially be considered for a revision lip lift and structural cheek augmentation, but I would not automatically assume that both procedures are necessary. The goal would be to determine what is actually creating the imbalance and then use the smallest number of procedures needed to restore proportion.

And I completely understand your hesitation about fillers. If you prefer not to use them because of your previous experience, there are surgical ways of addressing midface structure that don't depend on repeated injections. The trade-off is that implants and revision surgery carry their own considerations, including asymmetry, infection, shifting, scarring, healing problems, and the possibility of revision surgery.

Ultimately, your age itself would not be the reason to rule you out. Your current thyroid stability, any history of thyroid eye disease, the anatomy left after your first lip lift, your facial asymmetry, and the amount and location of midface volume loss would be much more important in determining whether this combination would give you the balanced, natural result you're looking for.

Gary M. Horndeski, MD · Answer

Yes, you would benefit from a lip lift revision. The scar on the right side appears quite thickened and needs to be excised. You also have a deep nasolabial fold on that side as well. A lip lift will improve it but you may want fat transfers as well. Fat transfers can be performed to the cheeks as well if you desire more volume.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Would a lip lift revision and cheek implants help me achieve a more balanced look? (photos)

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