In general, the more bones are resected, the more sagging may appear, especially if the patient is 30+ years old. In general there are 4 factors that influence the risk of getting saggy skin: - whether you have heavy fat on your cheeks - whether you skin elasticity is low There 2 depend on each individual skin type or body structure. - if you have to reduce the big amount of bone - the desquamation area is wide These 2 depend on surgeon's skills and experience. When the cheekbone reduction is performed the flesh of the bone must be separated. It's called "desquamation". After separating the flesh surgeon performs bone reduction and fixation. The problem is that when the surgery is finished the flash should be attached to the original position. However if you have a lot of fat on the cheek and you skin elasticity is low the skin cannot hold the cheek fat in position, so it will lead to sagging. In this case ID hospital analyzes each patient's skin condition, age and bone structure and if needed recommends Accusculpt laser or Buccal Fat Removal to remove excess fat and avoid sagging. With the right treatments and experienced surgeon there is no need to worry about saggy skin after the surgery. I hope it helps.