Is It Possible to Get Desired Result? (photo)

Dear Doctors, Is it possible to get the desired result (not by volume, but by skin lift effect). I do not want to have more volume at the cheeks area. I do not want to add volume at all, but I can allow minimal volume to any areas, but cheeks (minimal cheeks volume is okay). Can I expect lift effect without adding much volume which I show at "desired" picture? Where and how injections should be done? Which is the most predictable option? Fat, hyaluronic acid or predefined implants?

Doctor Answers 14

Yes You Can Get Your Desired Results

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Thanks for your question – and understand that using fillers adds volume. If you understand this and consult with a board-certified dermatologist or plastic surgeon that is skilled in the new “volumizing” fillers – Voluma and Perlane -- which we inject into the mid-face to improve volume and contour of the face, which, when done correctly, can take some of the nasolabial folds away. This needs a skilled injector to avoid too much volume.

And there are devices, such as Ulthera or one of the RF skin tightening devices that also may work well here. In the consultation, one will learn which one of these therapies is best for you

Nashville Dermatologic Surgeon
3.9 out of 5 stars 17 reviews

Lifting effect in the face -- surgery or filler?

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There are two ways to get to the result you are looking for: surgery or fillers to the cheek area. 

FILLING the cheek area will add volume to the face but create the lifting effect that you desire.  Perlane, Radiesse and Voluma are the best fillers for augmenting the cheeks and softening the nasolabial folds. All three cause some collagen production.  I have used all three products to obtain beautiful results in the midface and cheeks. Voluma costs more because it has been show to last the longest, and they are priced accordingly. If you go to a "core" injector (facial plastic surgeon, plastic surgeon, dermatologist, or occuloplastic surgeon), you should get great results with any of these products.  I would definitely recommend trying one of these products prior to getting cheek implants.  The advent of these injectables and the advances in mid-facial lifting has resulted in a significant decline in the number of cheek implants that are needed in my practice.

LIFTING the mid-face via surgery is another effective way to bring the soft tissues back to their native position without adding additional volume -- just repositioning the volume from one part of the face to the other. 

An in-person exam would be the best way to address your concerns.  It's best to go to a facial plastic surgeon or plastic surgeon who can evaluate your face and offer an honest assessment of the best way to accomplish your desired result (whether that be non-surgical or surgical). I wish you well!

Parker A. Velargo, MD
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 52 reviews

Fillers add volume

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Thank you for your question.

There's no way around it. Fillers add volume.  If you want lift but not extra volume, then perhaps a midface lift is more suited for you.

To be sure what might be right for you, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.

I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

How to get the results produced by manual manipulation of your face

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It has been my experience that whenever a patient has to use their fingers to move their face into a desired position to demonstrate their goals, surgery is the best option.  However, it is important to remember that you cannot necessarily accomplish with surgery what you can with your finger!  I would recommend seeing an experienced surgeon who is also familiar with the results that can be achieved by advanced injection techniques to obtain a treatment recommendation.  Best of luck.

Brian Biesman, MD
Nashville Oculoplastic Surgeon
4.8 out of 5 stars 43 reviews

Options for Liquid Facelift

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 Dear guitz, thank you for your question. Injectable fillers can be used to enhance facial volume, correct lines and depressions, and rejuvenate the face without surgery. Some common fillers in our San Diego practice include restylane, juvederm, perlane, voluma, radiesse, and sculptra. Consult with a an experienced facial plastic surgeon injector to review your options. Good Luck!

Roy A. David, MD
San Diego Facial Plastic Surgeon

Face lift without surgery

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I love Thermage which is a non-surgical face lift to lift the skin without injections.  Through radio frequency heat, Thermage builds collagen and tightens the skin, especially the jowls.  As far as injections, it really depends on the individual but I prefer Sculptra or Restylane to give volume which can be placed by the lower jaw or temples or nasolabial areas.  Be certain to find a board certified dermatologist with a great deal of experience in facial injections and lasers for the best cosmetic result.

Liquid facelift

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It is possible to get a very nice volume in most patients. You look like a perfect candidate for the liquid facelift. Often the cheek area is not the area to treat.  Sometimes it is better to treat behind the cheek area as well as in front of the ears and temples. In your case, it looks like injections in the mid-face would lift the nasolabial folds. For volume, I prefer Radiesse and Sculptra injections. I would stay away from facial implants as they can have multiple complications, are permanent, and do not change as your face ages over time.  This means you could end up looking very strange in later years.  With facial fillers, you can have an excellent result if done properly by an experienced injector.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 68 reviews

Facial Lift without Surgery

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For my patients with similar requests, I would typically recommend what we call an UltraLift. This procedure uses Ultherapy, ultrasound technology, which provides subtle,  non-surgical lifting and tightening of the skin; combined with Radiesse, which is a facial filler that provides immediate results by filling in the nasal labial folds.  I would also recommend slight volume added to the mid face above the nasal labial fold which will lift and reduce the fold without significant increase in cheek volume.   This tends to be very rejuvenating without making the cheek bones look more prominent. The nice thing about this combination approach is that the Ultherapy, takes about 8 weeks to see final results, while the Radiesse provides immediate results and lasts for about a year.  I definitely would avoid implants as I don't think that will give you the results you are seeking.  Good luck to you. 

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 72 reviews

Facial lift without surgery

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You are looking for a lift of the skin which is different from increasing volume. Fillers may help but you are correct in deciding not to over do the filling. Surgery would also help but you really do not have that much extra skin. You might consider a non surgical lifting of the skin with a procedure such as Exilis. This is a non invasive radiofrequency treatment that will tighten the skin a bit. It certainly does not do what a facelift does but in combination with a small amount of fillers you will get a good correction without scars or downtime.

Liquid Facelift vs. Surgery To Lift Cheek And Decrease NL Fold

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Thank you for this excellent question.  The answer is both. 

The orbicularis oculi muscle surrounds the eye and goes down onto the cheek. A lower eyelid blepharoplasty, if appropriate, with a lateral orbicularis muscle sling will elevate the cheek, decrease the nasal labial fold and improve the lower eyelid all simultaneously without any increase in volume.  If a blepharoplasty is not appropriate, a mid facelift is a bigger surgery that will accomplish many of the same goals.  

Your desired after effect in your photograph shows an almost flat nasal labial fold.  To accomplish this, I recommend a strong HA such as Perlane which is quick, simple and should last about one year.  

If you wish to avoid surgery, cheek elevation can be accomplished with a filler such as Radiesse.  However, this will increase volume.   

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.