Can a deep plane revision facelift bring volume back to my cheeks?

Question

I’m looking for a more permanent solution than fillers or fat. Lost a lot of volume in my face after a lower lift. I’m not sure where the fat went, but I’m hoping something can be done to improve my angular, flat cheeks. Not sure if the chin implant could be adding to the masculine look of my face. Any thoughts would be helpful. Thanks in advance.

Sean Alemi, MD · Answer

Thanks for your question and various photographs. It is common to become frustrated with fillers and fat grafting. At a certain point some patients feel that these solutions fall short of delivering really stellar results. A deep plane face lift is an excellent procedure to rejuvenate the midface and bring the cheeks back to a more youthful position. This is because a deep plane approach directly lifts the malar fat pad by releasing the tension points surrounding it. This will re-create the heart-shaped face of youth and reduce the flat, angular appearance you are concerned by. I am not able to comment on a chin implant without seeing a profile picture to assess your chin projection, but I can tell you that it is common for women to develop a slightly masculine appearance just with joweling in combination with excessive filler and fat grafting. The reason for this is that as the jowls become droopy, particularly in the setting of fillers or fat to camouflage these areas, the jawline takes on more of a broad, rectangular shape, which is quite masculinizing. Often times, just with an adequate lift of the fallen soft tissue you are able to restore a more feminine appearance to this region without requiring an implant. Again, a deep plane face lift would be an excellent way to get this result. I'd suggest that you seek consultation with a surgeon who does deep plane work. Best of luck!

Trevor M. Born, MD · Answer

Dear Dcimu10Thank you for your question and photos!  It is hard to assess results just from photos and without the surgical notes .  Facial contour can be changed very nicely and for a long term with fat grafting.  A secondary surgical procedure may be an option - but without an examination - this is very difficult to determine.With Warm RegardsTrevor M Born MD

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question.  If you pull your face tighter if doesn't solve the problem of lacking volume. You could perhaps look at facial contouring where you have filler injected in all areas of the face instead of just one.  This will improve the volume of the face as a whole not in just one area.  Sculptra or Profhlio are also other non-surgical treatments you could explore.  All The Best

Fernando Colon, MD · Answer

Judging just by your pictures it seems you had a nice and naturalresult from your first operation. Your concerns may be structuraland I am not certain a deep plane revision may on itselfsolve the issue. I will suggest you visit a few plastic surgeonswith experience on facial rejuvenation and facial implantsand get their opinions before undergoing another operation.Best wishes.

Ronald J. Edelson, MD · Answer

I agree with you that fat injections are a waste yet so many surgeons perform it. I’ve never seen it make a worthwhile difference. I actually think your facelift looks quite good and don’t think that a deep plane facelift will do anything worthwhile at all.

Barry L. Eppley, MD, DMD · Answer

It is not that you have lost so much fat volume, it is just that the sweeping back effect of the skin tightening from the facelift has by definition made the face tighter creating the thinner and more angular result. This is a very common effect from a lower facelift and most would consider your result to be very good and expected. That being said adding some volume back by any form of a deep plane facelift revision is the hard way to get a little volume. A less invasive and more effective approach is the placement of submalar implants over the massteric fascia through an intraoral approach.

William Portuese, MD · Answer

The goal of a facelift procedure is to tighten loose  facial and neck skin, tighten loose  facial and neck muscles, lift the jowls, and removal fatty deposits in the neck.  Adding volume to the cheeks is usually done  with cheek implants which offer a permanent augmentation, or fillers which offer temporary augmentation.  Consider placement of a chin implant augment recessive chin profile present in the photographs

Val Lambros, MD, FACS (retired) · Answer

The answer is no. More pulling on your face tightens it more. It does not add volume. In order to add volume you need to,,,,...add volume with fillers or fat or implants.  Your cheeks are already huge and cheek implants make no sense. The problem is not the cheekbone, its the area underneath which you could address with fillers or fat, my guess is 2 cc of HA filler under the cheekbone per side to start which will last about 1 1/2 years.   I've been doing fat for 30 years and can assure you that fat works quite well. 
Overall you've had a nice result

Can a deep plane revision facelift bring volume back to my cheeks?

Answers (8)

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