My cheeks lost volume and are saggy after weight loss. Is it possible to have a deep plane cheek lift only? (Photos)

Question

I am a woman (30 years old) My weight always fluctuated a lot, and I lost 10kg , my face lost volume so now is saggy, specially in the cheekbones,. Is it possible to do make only deep plane cheek lift by a small incision over the ear? I saw some surgeons do endoscopic facelift using deep plane technique, but I don’t need brow lift only cheek lift. In addition I had bichectomy before my weight loss, which made it.

Ari Wes, MD · Answer

Thank you for the photos. What I see is a deflated lateral midface with some hollowing below the cheekbones, which is what you would expect after buccal fat removal followed by a 10 kg loss. At 30, this is a volume problem more than a descent problem. A deep plane midface lift repositions tissue, but it cannot replace fat that is gone, and lifting a deflated cheek can make the hollow below it more visible.
To answer your question directly: an isolated deep plane midface lift through a temporal or periauricular incision is technically possible, and it can be done without a brow lift. It is rarely the right first operation at your age. What usually serves patients in your situation better is structural fat grafting to the midface and buccal hollows, which restores the volume you lost and is permanent. If an in-person exam shows true ligamentous descent on top of the volume loss, a limited midface lift can be combined with the grafting. I would see a surgeon who does both, so you get an honest read on which one you actually need.

Muhsin Yilmaz, MD, FEBOPRAS · Answer

A targeted midface or cheek lift may be an option in selected patients, but whether it can be performed through a small incision above the ear depends on the degree of tissue descent and the surgical technique used. Endoscopic approaches can address certain areas of the midface, although they may not provide the same correction in every patient. Since you have had both weight loss and a previous bichectomy, your concerns may involve a combination of volume loss and tissue descent. A cheek lift repositions descended tissues, whereas fat grafting may help restore lost volume. In some cases, a combination of the two may provide a more balanced result. At 30, I would recommend a careful assessment before choosing a procedure. An experienced facial plastic surgeon can determine whether an isolated cheek lift would be sufficient or whether volume restoration would be more beneficial for your anatomy.

Pedro Literas, MD · Answer

Yes, a cheek or midface lift can be performed without a brow lift, and in selected patients it may be possible to use a limited incision around the temporal hairline or above the ear. However, the best approach depends on whether your concern is primarily tissue descent, volume loss, or a combination of both.
At age 30, especially after losing 10 kg and having a previous buccal fat removal, I would be cautious about recommending a lift without first evaluating the volume deficiency. A lift repositions tissues, but it does not replace lost fat. In some patients, carefully planned facial fat grafting can restore cheek projection and improve the appearance of sagging without the need for a facelift.
In my practice, I frequently combine deep-plane lifting techniques with fat grafting when both descent and volume loss are present. For a younger patient, I would consider the least invasive approach that addresses the actual cause, whether that is fat grafting alone, a limited cheek lift, or a combination.
An in-person examination is important to assess your skin elasticity, cheek position, and the areas affected by your previous bichectomy. I would be happy to evaluate your case and discuss a personalized plan to restore a natural, youthful facial contour without unnecessary surgery.
Dr. Pedro Literas, MD, FACSFacial Plastic SurgeonCabo San Lucas, Mexico

Sinyoung Song, MD · Answer

Hi, this is Dr. Song.Based on your photos, I noted a loss of facial volume from rapid weight loss, as well as relatively thick skin with a noticeable degree of sagging. There is also some hollowing below the cheekbones (zygomatic area).
Through a minimal incision hidden within the scalp at the temples, we can perform a midface lift using the deep plane facelift technique, as you mentioned. While the surgical extent may be more targeted than a full facelift, it effectively lifts the midface. This will help soften the nasolabial folds you are concerned about and create the appearance of a shorter, more balanced facial profile. Furthermore, unlike a conventional full facelift, the vector of elevation in this procedure tends to pull more vertically upward. Given your relatively young age, this approach would be particularly effective.
To address the hollowing below your cheekbones, combining the lift with a subtle volume restoration procedure would yield better results. In Korea, treatments like Juvelook Volume or dermal fillers are frequently used for this purpose.
If I had the opportunity to evaluate your full face in person, I could provide a more precise recommendation tailored to enhancing your overall facial aesthetics.
Thank you.

Richard Tyrell, MD · Answer

Good Morning,There are a few options for midface (Cheek) lifting. Endoscopic approach uses a camera and small incisions in the scalp to release the ligaments, lift the cheek, excess skin is often removed along the lower eyelid if needed. With less dissection of the forehead, the cheek can be lifted endoscopically while minimizing the affect on the brows. Other approach's would place a scar more posterior in the scalp, (Temporal lift) and combination approaches involving incisions inside the mouth as well. 
BestRichard Tyrell MD FACS

Ronald J. Edelson, MD · Answer

What you are illustrating is not the result you would actually get. I would not operate on you but there are many surgeons out there who would. If you consult with a surgeon who does the type of procedure you describe they might advise the procedure and you may be pleased with it

Emre Guvercin, MD, FEBOPRAS · Answer

At 30, I would generally not recommend a traditional deep plane facelift solely for this type of midface and cheek deformity, as a standard deep plane facelift may be insufficient for specifically elevating the descended midface tissues. In your case, especially after significant weight loss and previous buccal fat removal, an endoscopic transtemporal deep plane midface lift may be a more appropriate option. This technique allows the cheek and midface tissues to be released and repositioned vertically through limited temporal incisions, without necessarily performing a brow lift or a full facelift. It can restore a higher cheek position and improve the sagging appearance while being more appropriate for a younger patient with predominantly midface concerns.

Julian De Silva, MD · Answer

Hi Independent18653, thank you for your question and photos. Losing 10kg often shows in the face first, and a previous bichectomy can add to hollowing in the cheeks. From your description there are two separate issues: volume loss and early laxity. A deep plane approach can be tailored to the midface and cheek through incisions in front of and around the ear, without a brow lift. However, at 30 with volume loss as the main driver, lifting alone can leave the face looking deflated rather than refreshed. In my practice I would often consider fat transfer to restore cheek volume, sometimes combined with a more limited lift if there is true laxity. The right balance can only be decided with an in-person examination of your skin, tissue quality and how your face animates. I would encourage you to see a facial specialist who offers both lifting and volume restoration, so all options are on the table.

My cheeks lost volume and are saggy after weight loss. Is it possible to have a deep plane cheek lift only? (Photos)

Answers (8)

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