What can be done about sagging cheeks after jaw surgery? (Photos)

Question

Female, 23. Had double jaw surgery in 2014. It left me with saggy malar fat pads that bulge out. I had no signs of this before surgery. Do these circumstances make me a candidate for a facelift? I think that most surgeons would suggest fillers or implants, but I don't desire fuller cheeks. I just want the tissue where it was before. I know I'm a bit hollow up top but it would take a ridiculous amount of filler to taper it. I have a long face and worry that too much filler will look freaky...

Joel B. Beck, MD, FACS · Answer

Thank you for your question!  It is very difficult to determine what you could benefit from with the photos you uploaded.  Being that you are only 23 years old, I would doubt a facelift would be appropriate unless you had significant jowling and/or loose neck skin.  There are a number of machines on the market that claim to tighten your skin.  We have Ultherapy which works especially in younger individuals.  Still, this may or may not be recommended by your local surgeon's office.  Fillers can be very useful for someone like you, but you have to repeat them regularly.   One thought that came to mind would be the use of your only fat, provided you have enough and perform fat transfer to add volume and change the long face appearance.  You may need 1-3 sessions of this since not all the fat lives in the new location, but I think this may be a good alternative.  I regularly perform fat transfer to the face, and often, it may even be effective enough for some people rather than a facelift.  It is also used in addition to face lifts as a "lift and fill" technique.  Well, I hope this helps you some.  I would probably get a few different consultations by a board certified plastic and reconstructive surgeon.

Sam Speron, MD, FACS · Answer

Hello,  I am sorry to hear about your condition, but you do have options available to you.  It is not likely that a face lift will do the trick, but a physical examination could prove me wrong.  I have seen patients do very well with a combination of cheek implants and Ultherapy when they display your characteristics.  Get an exam and see if your surgeon agrees.  It is tough to tell from your photos, but my guess is based upon prior experience.  Good luck to you.

Toby Mayer, MD · Answer

you may be a candidate for a cheek lift but I would need to see better photographs or examine your face to determine if this is a suitable option for you. See a very experienced surgeon for correction of this problem.

Jeffrey Jumaily, MD · Answer

I understand your concern. I would recommend volume to the face to get a better contour. If too much is required, consider fat grafting over fillers. Facelift at your age is not usually indicated. Of course in person assessment is helpful. Best wishes

Milind K. Ambe, MD · Answer

Thank you for your question and photos. You are definitely not a candidate for a facelift at your age and lack of true laxity.  I would recommend Ultherapy procedure if you are not interested in fillers. Ultherapy is a non surgical approach to improve tissue laxity (to give you a lift to the lower jawline and neck) plus it helps build collagen.  Make an appointment for a free consultation to discuss more details.  Best of luck to you

Curtis Wong, MD · Answer

there are many options for you to choose from and as mentioned by others, a face to face exam is needed and you do have to consider all options.  Yes, fillers and fat are fixes (consider fat and PRP if you are going that route) are the obvious but you can also consider ThermiRF that can help tighten your skin without 'surgery'.  At your age, avoiding facelifts should be obvious.

Moneer Jaibaji, MD · Answer

Thank you for the questions and photos. It is best if you have an in person consultation with a plastic surgeon to address your concerns. There are, in general, several ways to address the saggy malaria fat; fillers, fat transfer, surgery or combinations of the above are some of the means to address your concerns.

William Portuese, MD · Answer

A better set of facial photographs are required to make a determination about what may be needed.  At age 23, a facelift  will have No beneficial effect.  Cheek implants are placed for patients who have a flat maxilla and a long thin face.  The implants are placed directly over the maxilla in the area that needs most of the augmentation which is closer to the nose, not laterally.  Cheek implants are manufactured and a large variety of sizes and shapes, which is best determined at time of the consultation and examination, especially since  you have already had previous surgery.  In our practice, we use Implantech Silastic malar and sub- malar cheek implants for over 25 years. for more information, diagrams of the implants themselves, and many before and after examples of cheek implants, please see the link and the video below

Jarrod Little, MD · Answer

Orthognathic surgery will often result in a change in the soft-tissue appearance of the face.  You are too young to consider a true facelift.  Fillers are an option, but are not permanent.  Another option to consider is fat grafting.  Fat grafting is somewhat unpredictable, but offers the advantage of a longer lasting and potentially more natural result. As always, it is important to personally consult with a board certified Plastic Surgeon who at least has experience with facial fat grafting.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question but it is hard to make a recommendation from the photos alone.  So go on some complimentary consultations with experts in the area and get some in person recommendationsDr Corbin

What can be done about sagging cheeks after jaw surgery? (Photos)

Answers (11)

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