Is the only way to lift cheeks a facelift? (Photo)

Question

Hi I’m 29 and I’ve lost about 12kg recently; which has resulted in my face sagging and particularly around my mouth and nasolabial fold area. I’ve had about 6ml of filler but it hasn’t helped at all (some in cheeks and some in the actual folds themselves) please see the pictures. I really hate my face and how old I look. I think the only way to achieve what I want is a facelift. Is there a doctor/surgeon that will do one for me please?

Alan Gonzalez, MD, FACS · Answer

Dear @cdn19, thanks for your question and showing your pictures! A mini facelift can help to lift and tighten sagging skin on the face, typically targeting the lower half of the face and neck. While mini facelifts are often used to correct signs of aging such as jowls, wrinkles, and sagging skin, they are not typically recommended If skin looks youthful. It is very possible to improve the skin elasticity and define the edges of the face or mandibular line with a nonsurgical treatment like Ultherapy. This may be a non-surgical alternative. It is important to consult one or several board certified plastic surgeon for more information and recommendations. Best wishes!

Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

Bora Ok, MD · Answer

Hi from Istanbul, congratulations on your weight loss! Weight loss can indeed lead to changes in facial volume and skin elasticity, resulting in areas like the mouth and nasolabial folds appearing more pronounced. A midface lift combined with a facelift would be a more effective solution than fillers, as these procedures are designed to address sagging and restore a more youthful contour to the face. Best of luck to you.

Myung Ju Lee, MD, PhD · Answer

While there are many ways to enhance the loosen skin on the facial area, I would say facelift is the most effective and lasts longest way to lift up the loosen skin.Mostly, sunken areas of the face can be filled up with facial fat grafting or fillers, but there are limitations. These methods are mostly to give volume to the sunken area, while facelift essentially removes the excess skin by dissecting and lifting up the skin.For better diagnosis and recommendations, I recommend you to step in for an in-person consultation.I hope this helps!

Zeshaan Maan, MD · Answer

Facial fat grafting can be a very effective way to restore volume in a lasting way. This can be done either on its own or in combination with a facelift or other procedures. Your best bet is to have a consultation with a surgeon focused on facial rejuvenation who can assess you and formulate a plan to help you achieve your goals.

Richard G. Schwartz, MD · Answer

There is no doubt that a cheek or upper facelift would lift and improve your lower and upper jowl fullness, also reducing the nasolabial and marionette folds.  Alternatively, you could also consider another round of filler to add volume to your upper cheek regions, as this can sometimes lift up the lower cheeks slightly.  Occasionally, the non-surgical skin-tightening technologies can be helpful for younger patients such as yourself.

Ajaya Kashyap, MD · Answer

Thank-you for your query. You will need a careful examination and assessment , but based on your history and photographs, a mid face/cheek lift through a small incision on the side of your lower eyelid will benefit you significantly. A non surgical skin tightening treatment like HIFU or invasive radio frequency  ( like Thermitight or Facetite) can also be helpful, especially considering your age. Please find an experienced board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

Michael P. Morrissette, DDS, FACS · Answer

The cheeks can elevated with the soft tissue being repositioned with cheek implants. The implants are made of silicone and they are placed along the bone so you can't feel them through the skin. They would improve the flatness of your eyelid-cheek junction. The surgery is simple and can be performed in the office with sedation anesthesia.

Zoran Potparic, MD · Answer

Correction of nasolabial folds with fillers properly used would probably be major benefit. Cheek augmentation with fat graft or filler as well as jowls reduction with liposuction would be some of the options. You may start looking for a new consult. Good luck.

Gary M. Horndeski, MD · Answer

The goal is to improve the appearance of your face around your mouth. I recommend a lip lift first. A lip lift does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners. It will also soft the nasolabial folds. It takes about 1 1/2 to perform under local anesthesia and costs $3,000.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ruslan Zhuravsky, DO · Answer

Great work on losing that much weight! The unfortunate side effect to overall weight loss is the loss of facial volume along with the rest of it. Facial volume loss can certainly play a role in aging one's appearance as you have observed. With such amounts of loss, there is overall "deflation" of certain fat pockets. As these lose their fullness, the surrounding structures become more lax. Since it is a volume loss problem, such changes can usually be treated with volume reinflation. The key is that it has to be the right amount of volume and in the right areas. Be cautious with filling directly into folds, especially the nasolabial folds. With age related loss, there is bone loss in these areas and sometimes this is appropriate, but in weight loss cases, it should not be a very high amount of loss. It is also very easy to fill on the wrong side of the fold, injecting the nasolabial fat pad itself and making the fold worse. 6 ml may sound like a lot, but when you consider that it is 3ml on each side, it may not be adequate for the desired restoration. The lateral face and jawline are an important area to fill in cases like this, and they usually require at least 1-2 syringes per side of a filler that is strong and provides a lot of lift. Look for facial plastic or general plastic surgeons that do fat grafting as they will tend to understand the concepts of reinflation. Bring in pictures of your face prior to the weight loss. Good luck!

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