I am seeking to improve the peri orbital area and the midface. Lumpy under eyes, descended cheeks - recommendations? (Photos)

Question

My weight of 112 lbs has always been stable. I have thick, oily skin without fine lines/wrinkles. I have always had fat pads in a location which is too low on my face and deep nasolabials. I just tried Restylane to the pyriform fossa, no improvement. My goals are to restore a smooth transition from the cheek to the lower lids, to reduce the heaviness of the cheek tissue, and in general to lift a descended central facial structure, from the lower eyes to the perioral area. Thanks in advance for recommendations.

George Marosan, MD · Answer

Thank you for your question and photos. We all reach an age where fillers might not be able to correct more complex issues which happens with the aging process. Based on these photos without the benefit of a physical examination, you would do best with a comprehensive approach, most likely a full facelift, periocular surgery, removal of the cheek fat pads and shortening the upper lip. Recommendations from others to do "patch work" can be expensive, will not correct tissue descent or sagging and does not address the infrastructure. See a board certified plastic surgeon for an in person consultation/evaluation. Good luck.

Zoran Potparic, MD · Answer

What seem to be most noticeable on these photos is flat cheeks due to loss of volume, heavy nasolabial folds and upper and lower eyelids issues. Periorbital fat grafting, lower and possibly upper blepharoplasty would be a set of procedures to consider. However, what to do with NLF? Direct excision of nasolabial folds is something what my patients, when I propose it, immediately refuse because of “scars in the middle of my face”. Those who have had this procedure done  however, never complained about the scars which are always less visible then  folds. Something to consider and discuss with your surgeon. Good luck.

Lawrence Kass, MD · Answer

I am sorry that you have had such problems. I believe that you have festoons (also called malar mounds or malar bags). The treatment for this is not a facelift and it is not eyelid surgery. But a midface lift might be right for you. You may want to check out my page on festoons and also listen to the podcast put on by my subspecialty organization ASOPRS.  Good luck.

I am seeking to improve the peri orbital area and the midface. Lumpy under eyes, descended cheeks - recommendations? (Photos)

Answers (3)

More Facelift Questions

Is a deep plane facelift my only option or are there other suitable techniques/approaches? (Photos)

Which facelift technique would best achieve this amount of lower-face lift at age 30? (Photos)

Would the Bellafill be visible during a facelift and able to be removed?

Am I a suitable candidate for a facelift despite two very different surgical opinions? (Photos)

Can a facelift be done safely in the future after having Bellafill?

Why have I aged so rapidly in less than a year? How can I reduce my lower face/jowls? (Photos)

WE SEND PRETTY
EMAILS