What’s the point of facial lifting if the underlying bone structure is not addressed? (photos)

Question

Hi, I’m 23 and have sagging cheeks. It’s getting worse to the point that my fat pads make it hard to smile because they weigh so much. Would it be better to take an approach that lifts the fat pads/muscle, or should I focus on getting my bone structure augmented from a craniofacial surgeon? I’ve always had both low fat pads and weak bone structure, so I’m unsure of which of these factors is causing my cheeks to sag so much

Jason Emer, MD · Answer

It's difficult to say without the benefit of a formal evaluation. This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Randy Dean, MD - Account Suspended · Answer

Hi and welcome to our forum!
From your photos, I note a minimal lack of cheek projection and a slight degree of exaggeration of your nasolabial folds. 
I don't think you require a craniofacial procedure for correction. I have never experienced a patient complain of heavy cheek fat pads! Theoretically, the fat pads can be surgically elevated, but gravity will eventually overcome the correction. 
You may wish to try temporary upper cheek (malar) augmentation with an injectable filler, such as juvederm or radiesse to determine if it provides you with your desired look. In addition to filling out the upper cheek, it will provide a lifting effect to minimize the nasolabial fold. The effect is temporary, lasting 6 months or so. Many individuals undergo serial injections. For permanent correction, a cheek implant may be considered. 
Visit a board certified plastic surgeon for evaluation and discussion.
Best wishes...

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