36 y/o female - Would a blepharoplasty target volume loss in under eyes and mid face? Should I consider other options? (photos)

Question

I am 36 years old, and used to have a very muscular face from playing an instrument professionally. Now that I don’t play and am aging, the volume loss has given me really strange bags under my eyes when smiling, and my mid-face and cheeks also are volumeless and sag when not smiling. I have a very visible “ledge” look where the under eye transitions to the cheek when smiling. What’s the best bet at improving this area?

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. A lower blepharoplasty is an excellent option for smoothing the transition from the lower eyelid to the upper cheek area. During this procedure, loose muscles can be tightened and fat below the eye repositioned to add volume and create a firmer, more youthful appearance. In some cases, a facial fat graft may be necessary to provide adequate volume and achieve the desired result. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to discuss your concerns with you and determine the best course of action to help you reach your aesthetic goals.

C. Blake Perry, MD · Answer

The volume loss in the midface can be replaced with filler. The wrinkles under the eyes can be reduced with thoughtful neurotoxin. You also may be a candidate for lower lid fat transposition surgery but difficult to tell from the photos. Best to see an eyelid expert in your area. Best of luck.

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

36 y/o female - Would a blepharoplasty target volume loss in under eyes and mid face? Should I consider other options? (photos)

Answers (3)

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