What can be done to address sagging in my mid face? (photo)

Question

I have this fat/skin laxity by my nasolabial fold area. What can I do to lift this? I've already had ultherapy, liposuction on the chin and jawline, threads, filler, etc. nothing corrects the area I have circled in the picture. What is that part of the face even called?

Nelson Lee Novick, MD · Answer

While I am not surprised by the lack of success with ultrasound treatment, since this gizmo, much like fraxel lasers and other supposedly "next big thing" gizmos are backed far more by marketing hype and social media buzz than hard science. I am likewise not surprised by the lack of success with liposuction, since the removal of volume is more likely to worsen smile folds, marionette lines and even jowls along the jawline. What's more I gave up threadlifting ages ago since the results were unimpressive and not long-lasting, at best, and the procedure carries a high complication rate. 
I would strongly suspect that the lack of success with the fillers was because either an insufficiently robust filler was used for each area and/or the filler was not properly injected or injected in the wrong location to achieve the desired results. 
To achieve a nonsurgical filler facelift (that would improve both cheek contour and diminish the smile folds), a robust HA volumizing filler should be used in the appropriate location of the cheeks in order to lift the cheeks. If mistakenly injected directly into the smile folds, it can actually worsen them and make the cheek more jowly looking. 
An appropriately robust HA lifting filler, injected properly can also lift and straighten the marionette folds on the sides of the mouth. Once again, if not injected properly, the folds may actually become more pronounced.  When proper HA fillers are properly injected in the appropriate locations, the results are typically immediate and gratifying, and there is usually little to no significant downtime. 
You would be wise to make sure to consult with a board certified cosmetic dermatologist filler expert. Hope this helps and best of luck.

Erin Smith, MD · Answer

Hello and thank you for your question. Knowing more about your history, future plans and demographics would be helpful to provide you with a complete opinion. On brief view, it does appear as though you have deep nasolabial folds and marionette lines. These could be addressed appropriately with a fat transfer. I would recommend an in person consultation with a board certified facial plastic surgeon to best answer your questions and provide you with options tailored to your needs.

Robert M. Tornambe, MD · Answer

It sounds like you are a candidate for a Mini-Facelift since the various non-invasive treatments did not really work for you. Don’t feel badly that is fairly common.
 My favorite technique is the MACS short scar Mini-Facelift. Developed in Europe, it is the ideal approach for the younger patient, not ready for a full facelift, or patients who desire a less invasive procedure with a shorter recovery time. It addresses both the mid face area (especially the jowls) as well as the neck, if needed. Come see me or another board-certified plastic surgeon in our area to explore the best options for you.  Good luck

Anna Chacon, MD, FAAD · Answer

To address sagging in the mid-face, particularly around the nasolabial fold area, there are several options you might consider, especially since you've already tried various non-surgical treatments like Ultherapy, liposuction, threads, and fillers. This area of concern is often referred to as the "malar" or "cheek" area and can be challenging to treat if non-surgical methods have not provided the desired results.

Surgical Options: A mid-face lift or a cheek lift might be more effective for significant sagging. This procedure can reposition the deeper facial tissues and provide a more lasting lift to the mid-face and cheek area.

Fat Grafting: This involves harvesting fat from another part of your body and injecting it into the mid-face to restore volume and provide a lifting effect.

Advanced Laser Treatments: Some laser treatments can stimulate collagen production, which may improve skin laxity over time.

Radiofrequency Microneedling: This combines radiofrequency energy with microneedling to tighten skin and stimulate collagen production, potentially improving skin texture and firmness.

Consultation with a Specialist: Since you've tried several treatments without success, it may be beneficial to consult with a board-certified plastic surgeon or dermatologist who specializes in facial rejuvenation for a personalized assessment and treatment plan.

Each option has its pros and cons, and the best choice depends on your specific anatomy, skin condition, and aesthetic goals.

Camille Cash, MD · Answer

You may have the best result from a combination of treatments.  FaceTite uses RF technology to tighten skin.  It's a great option for those with mild to moderate laxity but who aren't quite ready for a facelift.  Adding Morpheus8 treatments can enhance your results.  See my website or a provider near you to learn more.

Kenneth R. Francis, MD, FACS · Answer

Dear Poledance,
There may be many options to address your "midface sagging" concerns.  They each have different levels of effectiveness, benefits and disadvantages, and duration of effect.  They also can range from very invasive, i.e. facelifting to very non-invasive, i.e. different chemical peel options.  I would suggest a consultation with an American Board of Plastic Surgery board certified plastic surgeon for an examination and an in depth discussion of your goals, options, budget and recovery tolerance.  Good luck!

Robert L. Kraft, MD, FACS · Answer

It’s important to recognize that liposuction can cause a sunken appearance which is why I do not recommend it to young people in these areas.  Many of the non-surgical methods have limitations, of which you are an example. A mid-facelift may be the solution, although an examination is indicated. Please see a board certified plastic surgeon who can obtain a full history and make a recommendation.
Best wishes,
Dr Kraft

Leonard Grossman, MD · Answer

You’ve already made quite a few mistakes by having ultherapy and the thread lift. Not only are they not very effective, but they do more damage by burning off the facial fat and this process results in the deflation causing sagginess. Depending on your age, your options may be multiple. You definitely need to be seen in person in order to determine the best approach. I hope this help you good luck from Leonard Grossman M.D. organic Plastic Surgery.

Darryl J. Blinski, MD · Answer

Based on the circle in your posted, photo a sideburn facelift with Endo laze treatment could effectively correct this area. Based to her best to virtual consult with expect fee to range from $5000-$8000

Mustafa Aydinol, MD - Account Suspended · Answer

If you would like to get this part improved the best and definitive solution would be a mid-face lift.I also see some fat under your chin, so a double chin liposuction will also be appropriate. If you would like to get a sharper definition and okay with scars, then you can also get a full face and neck lift. Good luck.

What can be done to address sagging in my mid face? (photo)

Answers (10)

More Dermal Fillers Questions

Can you put filler near biofilm? (Photo)

What can be done to treat a depressed, hollow area just under my nose? 46 y/o female (photos)

What can I do to achieve a more balanced profile? (photos)

Would biofilm form around fat?

42, is there anything I can do about my substantial pre-jowl pockets? (Photos)

Can 10 year old filler be causing puffy, wrinkly under eye creases when I smile? (photos)

WE SEND PRETTY
EMAILS