Can Cheek Lift Pull the Lower Eyelid Down?

Question

I read on some of your post where a cheeklift could be use to tighten lower lids. Then I read it could pull the lower lid down. I am wanting to get upper and lower lids done.  I want my lower lids tighten.  I have the empty space between eyes and cheek area. I have wrinkles under eyes and  extra skin and fat .  I am 41 years old. Does a cheeklift help or pull the lower lid down? I need a facelift but am to scare for that just yet. Thanks.

Philip S. Schoenfeld, MD, FACS · Answer

Everything that you have said is correct and the surgeon with whom you consult will tell you that all of the complications you have mentioned can occur with a cheek lift. From the looks of your photo, it appears that you are deficient in the midface and have some bagging (psuedofat herniation) of the lower lids. Your upper lids look decent from the photo you have provided. From the photo, however, you may want to consider interventions that augment your midface area. These can be fillers, fat, and even cheek/midface implants (not my first choice but it works well for some patients with thicker skin). Other surgical interventions would be a mid-face lift in conjunction with lower eyelid surgery. This would help with the bags and hollows beneath your eyes but, can lead to lower lid ectropion and you would still require some soft tissue augmentation as you are quite thin and need some fullness to the midface area.

Jason Emer, MD · Answer

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.

James M. Pearson, MD, FACS · Answer

Thank you for your question. A mid-face lift, sometimes referred to as a cheek lift, can help to restore fullness to the mid-face by vertically repositioning the soft tissue of the cheek to a higher, more youthful position on the cheek bone. At the same time, lower eyelid appearance is often improved as the repositioned cheek tissue is more favorably redraped over the lower orbital rim, minimizing the unfavorable hollow appearance of the lower eye region which corresponds to the 'empty space between the eyes and cheeks' that you note. When properly performed, the cheek lift should not pull down the lower eyelid. In fact, a 2005 study found that lower eyelid tension (ability to resist being 'pulled down') was improved following mid-face lifting when performed by the transtemporal subperiosteal approach (ncbi.nlm.nih.gov/pubmed/16027342). A well-performed mid-face lift can be a powerful method for facial rejuvenation. Learn more about this procedure on our site. Warm regards.

Otto Joseph Placik, MD · Answer

From your photo you do not need an upper eyelid.
Your statements are somewhat correct. If you do a cheek lift, you generally should also perform a lower eyelid tightening procedure. A cheek lift, in and of itself, does not tighten the eyelid but it can pull the lower eyelid down. A cheek lift could provide you with some improvement in the area of your lower eyelid and cheek.

Toby Mayer, MD · Answer

However, if properly done it won't. From your photo you may not need a cheeklift. See an experienced eyelid surgeon and let him guide you.

Sam Goldberger, MD · Answer

A properly performed cheek lift should position and secure your eyelids in the optimal position.  it should in no way pull your eyelids down.

Samir Shureih, MD · Answer

Looking at your picture, you look great.
Upper face does not need any thing, mid face, only the lower lids may need work either Transconjunctival blepharoplasty or filler to the tear trough. We do not see the jowls and neck.
A mid face or cheeck lift does not lift the eye lids. It will shorten the eye lid cheeck distance, more youthfull.
If the lower face need correctio then will consider facial rejuvanation with a face lift, trnasconjunctival blepheroplasty

Darryl J. Blinski, MD · Answer

As you can see, all the expert posters agree that you may not need any surgery, at least not at this time. Best to see in person 3 boarded plastic surgeons in your area to discuss. You must have realistic expectations.
From Miami

Peter A. Aldea, MD · Answer

A few comments.
A Cheek lift does NOT tighten the lower lids. If anything, lifting the cheek will demonstrate how much lower lid excess skin the gradual cheek sagging produced over the years and that skin will need to be removed leaving a thin scar under the lower lid lashes.
A cheek lift will largely erase the nose to side of mouth lines and increase the fullness of the cheeks. If your lower lid is loose, any post-surgical swelling WILL draw the lower lid DOWNWARDS producing an ECTROPION (Google picture this). In such cases the lower lids MUST be tightened with EITHER a CANTHOPEXY or a CANTHOPLASTY (based on the amount of give). The lifted cheek MUST be securely anchored to prevent it from falling. If it were to fall, it WILL pull the lower lid down.
Before having any of this done, have a competent Plastic Surgeon in your area (not another subordinate injector) inject the Tear Trough lines with Restylane. The results may surprise you and stop you from having this large operation.
Dr. P. Aldea

Richard W. Fleming, MD (retired) · Answer

If not done properly, a cheek lift can pull down the lower eyelids. A cheek lift will not tighten the lower lids, but a lower lid tightening can be done in conjuntion with the lift. 
Perhaps it is my computer, but I question if there are bags of your cheeks below your eyelids. If this is the case, at least a partial cheek lift may be indicated. See an experienced surgeon to set reasonabe goals and expectations.

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