Does sleep deprivation cause volume loss? Will a fat transfer or implants to the cheek be a good solution? (Photos)

Question

My cheeks and under eyes have lost volume. I have a one year old and don’t get enough sleep. Does sleep deprivation cause volume loss? Is it reversible? If not, best option for natural look? I don’t want to do fillers as they aren’t permanent. I am 22 and feel I look so aged, making me very depressed. Should I do a cheek lift of sorts?

Jed H. Horowitz, MD, FACS · Answer

Hello janeCheek implants are used to increase the projection of the cheekbones. They increase the fullness of areas of the cheek that may be receded or flat. Cheek implants add body and contour to cheeks that lack definition. Fillers such as Juvederm Voluma, Radiesse and RestylaneLyft are great alternatives to cheek implants, also fat transfer or injection can be done.

Amir Nasir, MD · Answer

Congratulations on your new baby! There a number of factors that can contribute to that tired look. Most commonly things like dehydration, lack of sleep, stress, aging (not in your case because you're 22!), stress, etc... Right now you are probably suffering from most of these issues simultaneously. I would recommends seeing a Board Certified Plastic Surgeon to discuss fat transfer vs fillers. My initial reaction would be to do neither on someone so young who has just had a baby and see if there is a way to help you get more sleep, more fluids, and less stress in your life than you likely have. If that is not possible then perhaps a small amount of filler may give you the results you are looking for. Again, this is not something I would advocate unless you speak to your surgeon about it in person and they are able to examine you properly and discuss your health and medical history.I hope this helps!

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheek implants, chin implants, lip implants), liposuction and/or facelifts for over 30 years.  From the photos, your cheeks are very flat in the front and the chin is quite weak.  This combines to create an elongated, rectangular-shaped face.  
 Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  When the cheeks are either flat or concave in the front, cheek augmentation with a dermal filler or using silastic cheek implants (for a permanent enhancement) can create full, round cheeks that will feminize the entire face.
 I have performed many Chin Augmentations using chin implants for over 30 years.  From the photos, your chin is weak.  A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. 
 I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty.  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.
 As one would expect at 22 years of age, your face does not show signs of jowls in the lower face.   As described below, you would therefore not be considered a candidate for any type of a facelift.   I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years.  In my experience and despite its recent increase in popularity, fat transfer (fat injection) offers "far" less of a reliable and predictable volume for facial shaping than an off the shelf dermal filler or silastic facial implant.  For that reason, I do not use fat to shape the cheeks, chin, lips or jaw line.  Tissue physiology is quite simple.  Tissue requires a blood supply in and out as well as lymphatic connections to remain viable and alive.  Once fat is removed from the body all of these things have been disrupted.  Just because the removed fat is mixed with PRP or something else doesn't make the blood and lymphatics magically re-appear.  The fat at that point is not living tissue which means that it's prone to being dissolved by the body (most likely in an uneven and unpredictable manner).  Injecting fat back into the face does not create the required elements to make the fat living tissue once again.  So the argument that fat is alive and viable in the face once it's been removed and re-injected makes no sense to me as a physician and surgeon.
 The other issue that I have with fat transfer is the lack of precision.  Fat is thick by nature which means it's not the same consistency as an off the shelf dermal filler.  Fat injections use an increased volume injected in an attempt to compensate for the volume loss that "will" happen.  This means a lack of specific shape and volume that simply can not begin to compare with the specificity of using a silastic facial implant of a "known" shape and volume.  In that regard fat offers too much of an unknown to make it a reliable and predictable method for facial shaping.  There's a significant difference between a 3mm and 5mm thick cheek implant.  You can imagine the magnitude of difference there is between retaining 60% of 25cc's of fat versus 35%.  In my humble opinion, I just don’t see how fat could possibly be used to precisely shape facial features?
Hope this helps.

Does sleep deprivation cause volume loss? Will a fat transfer or implants to the cheek be a good solution? (Photos)

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