Is the issue with my face from volume loss or sagging tissue? (photos)

Question

I had my buccal fat removed years ago and have since lost 40 pounds. I am concerned with the drawn look of my face, I have one doc recommending a cheek lift and another saying fat transfer. I am 48. Which appears to be the issue? Loss of volume or sagging of tissue?

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your concerns and posting your photos. There is both volume loss and sagging of your midface. Both issues could be corrrected with proper placement of fillers. See an experienced oculofacial surgeon for evaluation and treatment. Good luck,

Nelson Lee Novick, MD · Answer

The photos show clear evidence of significant volume deficit throughout the cheeks, which is largely responsible for the incipient hollowness below the eyes, the sunken central cheeks, the deep smile lines, and the jowls along the jawline. The recent weight loss that resulted in shrinkage of the superficial fat layers simply "unmasked"  the volume deficit below that gradually and inexorably occurs for everyone. The use of robust HA volumizing and lifting fillers, in the hands of an experienced injector, can quite easily address these problems in a 45 minute treatment session. You would be wise to consult a board certified cosmetic dermatologist injector and best of luck.

Michael I. Echavez, MD · Answer

In my opinion, I would say that the major issue is loss of volume in your face rather than sagging tissue.  I think that adding volume to your face would provide rejuvenation for you.

David M. Creech, MD · Answer

Full exam is necessary. An option is a sub periosteal mid-face (cheek lift). This involves surgically lifting your entire cheek, vertically. This method reversers the vertical drop of your cheek soft tissues that causes the Nasolabial fold to get fuller and the cheek bone to look flatter due to the aging process. With that surgery fat can be used to further improve your cheeks.

William Portuese, MD · Answer

You have both sagging tissues in your face and neck most likely related to the significant weight loss, and you have volume loss in the cheek area from the buccal fat pad removal. A lower face and neck lift with fat grafting to the cheeks would be your best solution

Darryl J. Blinski, MD · Answer

Nicely posted photos! I recommend mini face/neck lift with SMAS plication plus either HA fillers, fat grafting to sub malar zones and naso labial folds (approx. 6 syringes r 30 cc's of nano fat). Fee $15,000. Best to virtual consult with...

Is the issue with my face from volume loss or sagging tissue? (photos)

Answers (7)

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