Cheeks Sagging at 34? (photo)

Rapid or repetitive weight loss and weight gain may contribute to jowl formation (as well as prematurely sagging skin all around). Cigarettes and excessive sun exposure also contribute to accelerated loss of tissue volume in the face, which leads to jowling. For now, I advise you to pursue non-surgical jowl lift under the care of a board certified dermatologist or plastic surgeon. Radiesse looks to be the ideal filler for your needs.

A combination approach would give the most improvement. Deep wrinkles and smile lines can be improved with a combination of Botox and/or fillers for the lines themselves and to build anatomical support with Sculptra for collagen building. Ultherapy is a great skin tightening device, but works best in combination with other treatments like J Plasma, RF treatments, lasers, microneedling/PRP, salt facials, Cosmelan for skin tightening and improve skin tone. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

Hello lin204Cheek implants are available in a range of different shapes and sizes, they are mostly customized to fit a specific facial structure. Fillers such as Juvederm Voluma, Radiesse and RestylaneLyft are great alternatives to cheek implants, also fat transfer or injection can be done.

A 34 some individuals may have modest volume loss in the periorbital area. This is easily treated with fillers.

The drooping of your cheeks is a natural age related change.  At your young age, I would recommend Radiesse filler to the cheeks.  This can help restore the "apple" back to your cheek.  The downside is that it only lasts 1 - 2 years.  Autologous fat transfer is another option, but in my experience can be unpredictable.  I don't think message will be of benefit.

Surgery for the sagging face is usually needed to remove the excess. I would need to see better photos to say what type--facelift probably. Fillers can temporarily improve the depressions but have to be repeated every 1-2 years.

It is not easy to give you an educated answer without all the facts. That is important. If it is just a volume issue then fat grafting can be done and there is no scars or incisions. You could also consider a cheek implant, but a physical exam is best to decide. My best advice is to visit with a board certified plastic surgeon who will truly access your issues and give you an honest opinion vs the opinion you want to hear.

the photo does show early jowling. Possible correctional techniques to consider:

weight loss, radiofrequency skin tightening (thermage), infra-red skin tightening (Cutera's Titan), Liposuction +/- S-lift, Fillers such as Voluma in front of the jowl fullness to minimize the jowling.

 

Ask you surgeon the benefits of each as well as the results, complications etc

in this limited photo you do appear to have some descent of your malar cheek area and jowl. At 34 this may well have a genetic component to it. Options could range from volume filler such as Sculptra to some form of cheek lift. It would all depend on a complete exam and discussion of goals.

The natural aging process causes our cheek volumes to descend, evacuating the under-eye area, causing pronouncement of the nasolabial folds, and contributing to the creation of the jowls. Looking at your photo, it would seem your cheek volume is changing in the normal, expected manner, but potentially a little early. Do you have hyper-reflexive joints? Easy bruising? Excessive skin laxity? Any family history of connective tissue disorders such as Ehlers Danlos syndrome? I would make sure all the answers to these questions are negative before doing anything.  You mentioned you would like to avoid surgery, so that leaves less invasive methods. I think injectables would be the most beneficial:  Sculptra to your high cheeks/cheekbones, Restylane to your under eye area / tear troughs, and perhaps Perlane or Radiesse to your nasolabial folds.  All of this can easily be done in the office in just a short time. And no surgery! Good luck  -Dr. Capone