I'm 43 years old, lost about 45 lbs, and now have hollow eyes, cheeks and nasolabial folds. My face looks tired and hollow. I have some old acne scars on my cheeks and noticed that when I lift up the skin, the scars flatten out, fold lines dissappear, and underneath my eyes no longer look hollow. Would just a Mid-face lift work for these issues or would I need Fat Transfer for eyes and fold lines, and Scupltra for scars and endoscopic mid face lift instead?
Mid-Face Lift for Tired-looking Face with Acne Scars?
Doctor Answers 8
Facelift for Acne Scars
In general, a facelift can be used to soften acne scarring especially in the outer cheek area and can be done in combination with laserbrasion and/or scar excision and fat augmentation to these areas.
Facelift and acne scars
A facelift helps with soft tissue descent and repositions tissues back to here they belong. Acne scars are different and probably will not improve with a facelift. They can be treasted a lot of different ways based upon the way they look.
Acne Scars and a Facelift
I would recommend seeing a plastic surgeon in person. Typically you will want to do a lower face and neck lift with a fat transfer at the same time. There are also several laser treatments that may help with your acne scars. Good Luck!
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Midface Sagging and Acne Scars
Midface sagging is a complex problem for which there is not a cookbook response. It can involve a variety of procedures including facial fillers, midface lift, cheek pad lift, etc. Acne scarring does not improve with facelifts or midfacelifts and requires separate treatment.
Think of facial aging as having multiple layers
Factors which conspire to ravage our faces include age, weight gain/loss, sun exposure, acne scarring, etc. At age 43 with a 45lb weight loss, you have correctly identified facial lipoatrophy (fat loss) as a major factor in the mid-face sag. Find a board certified PS or FPS who shares your aesthetic vision. Help them by sharing older photos of your face, when it was fuller and more youthful. You are right that the midcheek lift can reposition your native skin and SMAS (underlying soft tissue) to create a prettier cheek mound. However you may also need some volume to replace the fat, which melted away with age and weight loss. Structural fat grafting is a very powerful tool in facial rejuvenation. Incidentally, structural fat grafting confers some improvement to the overlying skin. good luck.
You describe the multiple changes which occur with midface aging and weight loss. I am a big fan of the midface lift to treat the problems you describe. By lifting these tissues, you have demonstrated the changes that occur with this procedure. Fillers such as fat may be necessary to increase volume in residual hallows or acne scars. An experienced surgeon will make specific recommendations.
You have a few concerns which have many different options. The definitive answer will be found when you meet the qualified surgeon that you wish to perform the aesthetic surgery.
A mid face lift may be a good option and combining this with fat grafting will be better as volume in the face will be restored in the areas that you have noted such as around the eyes, cheeks and folds.
Blepharoplasty or eyelid surgery may be needed to provide some correction.
Acne scarring is always challenging- but this will not change much with a lift alone.
With Warm Regards
Trevor M Born MD
I prefer fat transfer for a more natural appearance
Fat transfer could be your answer. Many times, the cheek area and lower eyelids appear the way that they do secondary to a loss of volume in those areas. Fat transfer is the best thing to make the area look natural. It’s not magic, but when done right and with enough attention, it can seem like magic.
A midface lift, in my opinion, results in less than optimal improvement of the area. You can't really take that much skin from a midface lift. Also, with a midface lift you can end up with eyelids that are pulled down like a hound dog. It also doesn't look natural and you often get bunching in the lateral eyelid area. I think that a midface lift is only beneficial when you need to improve the lower eyelid when there is a problem with the lower eyelid function. Once you plump up your midface with fat, you can concentrate on improving the acne scars with different types of procedures including resurfacing and excision of your scars.
Consulting a Board Certified Facial Plastic Surgeon would be something that I recommend. We specialize in the face and are highly qualified to help you with this.