Cheek Filler or Mid Face Lift?

The approach to the lower eyelid and cheek (midface) is a very controversial and sometimes intimidating area of the face, and as you can see from most answers the majority of plastic surgeons want to perform fillers in this area which is fine though when looking at your face and your complaint, you have the typical negative vector orbit with a flat midface and early descent of your soft tissue. Fillers are only going to partially correct this, so I would recommend consulting a midface specialist who would lift your cheek and smooth out your lower eyelid, as well as add volume to this area. I perform this either through the lower eyelid or with an endoscope through the brow. It can be a technically challenging procedure though long term would likely address your concerns. Let me know if you have questions.

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

With the limited information given: you seem to have a face that is genetically narrow, without a cheek/ogee curve.  Filler can help, but you are young, and will be repeating the filler quite often, an annuity for your facial plastic surgeon or dermatologist.  While I rarely perform cheek implantation for aging,  a "shell" type of implant would look natural, if done in the right hands with the right perspective and add to your attractive appearance.  For the laxity of the skin from smoking, there are good non-invasive treatments such as Ulthera that can help, but they won't lift the cheeks.
i've written and published extensively about mid-facelifting, but think an implant (with limited information) might be more useful.  Try smiling in a mirror, and see if the cheeks lift up and give you volume.  If a lot of volume is restored, then you might consider a mid-facelift

You are the prefect candidate for some fillers and superficial skin tightening techniques. As you mentioned, the heart face is what people are after these days. With precisely placed  fillers and some targeted skin treatments there is no doubt you can get back to where you want.  I recommend finding a surgeon you trust and being clear with your goals. I also recommend to go slow. You are a pretty woman and should take care to enhance what you have in order to get to your goals. Hope this helps,Best of luck,DrC

Thank you for your question.  Thank you for your picture.  It would be too premature to perform a mid facelift as you do not have enough skin laxity.  I would suggest creating some volume within Juvederm Voluma Filler.  This would create a lovely contour and fullness.  This is also temporary and can be dissolved if you didn't like it.  The filler lasts approximately 9-18 months.  All The Best 

One's age is best guessed by the appearance of their face. If you feel that your face does not reflect how young you feel inside, you may be a candidate for a facelift.During your #consultation,  your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect.If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.

Dear Deni;It looks that your cheek bones are smaller, condition that is known as malar hypoplasia. People with such a bone structure will experience signs of "aging" much sooner then those with normally developed bones. Hollow, concave cheeks, elongated, hollow lower eyelids, tear trough (groove between cheek and eyelid) are typical signs of this condition.To correct bone deficiency (malar hypoplasia)  best option would be to place cheek silicone implants on top of cheek bones. That will correct the size of cheeks, lift and stretch soft tissue on top of it.  That may be all what you need. If additional volume is needed to create fuller and firmer cheeks, fat grafts or soft tissue filler (Juvaderm Voluma, Radiesse, Restylane) can be placed in soft tissue above implants. This relatively simple surgery is done through an incision inside of the mouth or inside of the lower eyelid. Both implants and fat grafts (soft tissue filler) can be done in the same time.Other option would be simply adding volume to build soft tissue only. In my hands this is best achieved with patient's own tissue in form of fat grafts. Soft tissue fillers, however, may be a useful first option just to give you an impression of how much improvement you may expect with any form of cheek augmentation.This is how you can get your heart shape face back. Good luck.

A facelift or mid facelift is an excellent option to regain volume in the mid face.  However, newer fillers such as Voluma, Sculptra, and Radiesse are excellent options in my office to restore volume without surgery. Best, Dr. Karamanoukian

Don't be too hard on yourself. Fillers, Fat transfer and/or a cheek lift would all be of great help to you (as well as stopping smoking). See a well trained board certified plastic surgeon to find out which is best for you.

Certainly these are all viable options for cheek pad descent and central facial aging.  There are several advantages and disadvantages to each form of correction and to some degree they all would work.  Facial fillers are the most temporary solution but also reversible.  They are the cheapest solution initially but since they only last about a year with repeated treatments they can become expensive.  In general it takes a lot of filler to see a difference.  Cheek implants are a more permanent form of soft tissue augmentation but involve a surgical procedure to place the implant.  Any implant can get infected or malpositioned.  Finally a mid facelift repositions the normal fat pad back over the cheek bone this may drop again with time but generally last about 10 years.  Before and after photos as well as a 3-D animation of the the procedure can be viewed at my website plasticsurgerynorthwest.com

Thank you for the picture it makes commenting much more personal. I would suggest that you not have surgery at this time and try something non invasive to see if you like the result. I would use Radiesse in your cheeks and believe you would see an excellent elevation of your cheeks and that this would translate into your perception of your face being transformed back to a heart shape. If you like the results you can then have some fat grafting done for a more permanent correction. Of course the cessation of smoking will only add to your skin quality.