Should I get fat grafting or a midface lift? (Photo)

Thank you for the questions and photo's.I would not feel comfortable giving you advice based on a photo in this situation.At your young age, your face is going to go through a LOT of changes over the next many years and as we age, we actually lose a lot of volume that you will want back if you try and remove at this point.I would consult with a facial plastic surgeon that you feel comfortable with and come up with a solution and a long term plan.I can tell you are not satisfied with the way things look right now but it is a terrible feeling to spend money on a procedure and still not be happy.Hope this all makes sense.

Thank you for the question. I wish you send more photos. It is difficult to make a conclusion based on your single photo. You are young for a routine mid face lifting procedure but your mid face is also deformed way too much compare to your age. 
Please visit a board certified plastic surgeon and let him or her give a full face to face exam and discuss options with her or him. 
Hope this all makes sense.

For your case, you can consider as the first option the use of fillers, this will replace the volume on the cheek area, where there is a lack of volume, and in the lower eyelid junction with the cheeks, the nasolabial fold will be the last area to correct. The advantage of the fillers is that in case you do not like it, they can be dissolved. Fat grafting is another option, but it is more invasive and requires more recvoery time, also the results are more long lasting, but the results are not reversible in case you do not like them. Please consult with a Board Certified Plastic Surgeon, for an evaluation in person.

Based on your photo, the hollowness under your eyes, around your midface seems like it can be improved by fat injections/fillers. A facelift might be irrelevant and too radical if you do not have a lot of excess skin. Volumizing the face can also prove a tightening of skin. A buccal fat removal may also be beneficial to reduce the chubbiness in your lower cheeks. It's best to consult a board certified facial aesthetics surgeon in person and discuss your options after a physical examination.Hope this helps,Ali Rıza Öreroğlu, MD FEBOPRASEuropean and Turkish Board Certified Aesthetic, Plastic and Reconstructive SurgeonIstanbul, Turkey

Thank you for your picture. Given your age, I would not recommend a mid-facelift procedure. I would suggest fillers, including fat if you want to "see" your results with such therapy. If you want a longer lasting result, relocating the fat of your lower eyelids to fill the tear trough deformity would be a more lasting result. You can see such results in patients with a more significant deformity in the web link provided. Look at case # 2113.For the naso-labial fold concerns you have, fillers look like the best option for you.  Michael Kulick MD
   Board Certified Plastic Surgeon San Francisco, Ca. 
   Member of ASPS, ASAPS
   Clinical Editor of the Aesthetic Surgery Journal
   Recipient of the Klingbeil Award from ASAPS – Teaching Safe Techniques and Advanced Technologies

Hello, Thanks for your question. As you are young and healthy, you have several options. Most patients your age do well with injectable filler or fat. If you are very active, filler is a better option than fat. Another option is the placement of cheek implants. It is a permanent option with a great safety profile during and after surgery. A midface lift is probably not a good option as it carries the highest risk for you and can be a long recovery. The shadows you see are the result of bone deficiency in your midface. Normally we see this in people who have aged, but you were born this way. I've seen many patients in their 20's with this problem and most just choose to have filler injection because it is the most economical and safe option. It's only downside is the fact that filler isn't permanent and has to be re-injected on a yearly basis for most filler products. I would recommend that you consult with a board-certified plastic surgeon to discuss your full range of options.Good luck,Dr. Shah

There are both temporary and permanent options. Fillers and/or fat can be used to increase the volume of your cheeks and diminish the depth of your nasaolabial folds. If you prefer a more permanent solution, I would recommend silicone submalar implants. A midface lift is indicated for significant jowling. In your case, cheek implants would best address the loss or lacking of midface volume.  

We try to make the correct diagnosis before we come up with a treatment plan. It appears that you have malar and sub malar hypoplasia and mid face ptosis . You would benefit from a malar submalar implant and mid face lift. Most people may recommend filler to the mid face and cheek. This could be fat or commercial filler. The reason I recommend against this is for you is that your contour deformities are significant, your young and you will pay for a lot of fillers over the next several decades. FILLER FATIGUE.

You definitely don’t need a facelift.  You do have a thick ridge along the front of the cheeks which you have pointed out.  Some localized liposuction if that area could be a worthwhile option. 

From the limited information on your pictures, you are a candidate for either fillers or mid-face lifting, depending on how long you wish the procedure to last and the “naturalness” of the procedure.  You need a procedure with a board certified facial plastic surgeon to determine this.