I'm thinking about Voluma for my sunken cheeks, I also am thinking about a lower face lift. Which should I do first. (photos)

I did protege elite to tighten collagen. Had 6 treatments. My before pic is much better. The Dr said he could fix the sunken look with voluma. I'm 62. He also recommended that product because I have an immune deficiency disease. I won't be seeing that Dr again.

Doctor Answers 14

Lower Facelift Under Local Anaesthetic

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your question, having a lower facelift I would suggest a lower facelift firstly as it would definitely provide you with a smooth, contoured jawline and neck.  Lower facelift is suitable for patients wanting to reduce sagging in the lower face and neck and regain a more natural, rejuvenated appearance.  The procedure is less invasive than a traditional facelift and there is less scarring, bruising and swelling for a significantly quicker recovery period.  The Concept™ Facelift and Neck Lift I have pioneered can be performed under local anaesthetic (some people may opt for twilight sedation).

What are the benefit of The Concept Facelift, under local anaesthetic?

  • Minimally invasive as it is a short scar facelift
  • There is minimal bruising and swelling, especially when compared to traditional facelifts
  • As the procedure is performed under local anaesthetic, you can go straight home following the procedure
  • Full recovery in a matter of days rather than months
  • Significantly less risk than Facelifts performed under general anaesthetic
  • Fresh, youthful and long lasting results

The Concept facelift procedure targets the muscle and skin therefore giving a longevity of 7-10 years, the same as a traditional facelift. This can be combined with other procedures such as cheek lift, eyelid surgery etc.  If you still wanted filler, a few weeks after once the swelling has diminished this could be performed.

Please make sure you find a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve.


All The Best

I'm thinking about Voluma for my sunken cheeks, I also am thinking about a lower face lift. Which should I do first

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I would suggest the lower facelift be done first. I would then wait about 3-6 months to allow all of the  swelling to be gone and then consider whether the fillers are needed at that point

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Based on the picture posted, a full SMAS facelift is all what is needed. This will re[position the fat that has dropped to normal position and give a natural rejuvenation of the face.

It all depend on the expertise of the surgeon in facelifts

Samir Shureih, MD
Baltimore Plastic Surgeon


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

In my practice, if a patient would benefit from a facelift, I recommend that procedure be done and then utilize secondary procedures such as fillers, peels, lasers, etc. The facelift is the foundation of creating a youthful look.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Foundation for Facial Rejuvenation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

At age 62, minimally invasive collagen tightening treatments will begin to to have declining returns.  If you are looking for a long lasting result that addresses the cheeks, jawline, and neck, a facelift is the best solution.  Facelift has no alternatives or competitors as the foundation of facial rejuvenation.  If properly performed, it can be "self volumizing" by the redistribution of SMAS and soft tissue during the procedure.  Voluma can be added at the same time or at a later date. 

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 103 reviews

Who is a Lite Lift™ Candidate

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

During your #consultation, your skin texture and elasticity, as well as your underlying skin structure and your facial bone structure will be evaluated. Based on this evaluation, your board certified plastic surgeons will create a custom surgical plan, detailing specific techniques and recommendations to meet your goals. In doing so, he or she should be sure to have a full understanding of what results you expect.

If you are not a #candidate, your surgeon can make other suggestions to address your concerns and objectives.
Patients who desire facial rejuvenation that is affordable, quick, and effective should consider the Lite-lift™. Like the Life-Style™ facelift, this is a modified facelift that can be performed in the office with a local anesthetic and improve signs of aging around the neck, jawbone and lower face. These procedures are not "Thread-lifts" or "String-lifts". We do not use the "barbed" sutures employed in these other lifting operations. The Lite-lift™ uses longer lasting techniques that are discussed below. Because the incisions are limited, there is less bruising, swelling and healing time for most patients. Many patients can be back to work in one to two weeks looking rested and more youthful.
The best candidates for #LiteLift are non-smoking patients 35-60 years old with early changes of the lower face and the neck. But whose skin has elasticity with well defined bone structure. Older patients who cannot or do not wish to have a longer operation or general anesthetic may also be a candidate for a Lite Lift™.

It is also possible to #combine #surgeries. In fact, I commonly recommend other procedures to go accompany a facelift, such as blepharoplasty or a midface (cheek) lift, to name a few. The combination of multiple of facial procedures may create an optimal result.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Facelfit or Fillers

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Sunken cheeks are best treated by treating the sinking.  The problem is depression not falling, so pulling the tissues does not address the problem.

Your fat or natural fillers such as hyaluronic acid gels such as Juvederm Voluma can replace lost midface volume. This can be performed first.

Your neck will best be addressed with a lower facelift.

Facelift or Voluma first?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

No question about it.  A comprehensive facelift with necklift will be the best answer to address multiple concerns for you.  

Voluma is wonderful at addressing volume issues and bringing balance to the face when enhancing the cheeks.  However, based on your photos there is laxity of the skin and underlying soft tissue / muscle layers in the mid to lower cheeks, jowl area, and neck.  In my opinion, addressing these areas will provide the best overall improvement for you and be more cost effective in the long run.

 The effect from Voluma alone cannot fully correct the issues and will only be temporary lasting on average about a year and half.  Addressing volume after surgery can be helpful if needed.

Consider an in-person consultation if you would like to take some time to discuss your concerns one on one and review the best options specifically for you.

David W. Rodwell III, MD
Charleston Facial Plastic Surgeon

Face lift and facial volume.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi Shydi,

Yours question comes up often. Which to do first. It depends a lot on your schedule and preference. A terrific approach is to do them together. If you can have the lower face lift in the near future, I would suggest adding the volume to correct the deficiency under your eye at the same time. We don't have to use Voluma, another choice is to use your own fat. Fat has the potential to provide permanent volume to the area. Voluma is terrific and we use it as an office procedure all the time. But if you are going to be in the OR, you can consider using your own tissue. If you can not do the lower face lift in the near future, it is fine to do the Voluma now. Just make sure your appreciate that its there when you do get around to the surgery.

An important consideration is your immune deficiency disease. You would, of course want your plastic surgeon to work closely with whomever takes care of this for you to make sure you are an appropriate candidate for surgery and not put you at risk of infection or wound healing.

Best of luck,

Dr. Bernard Shuster

Bernard A. Shuster, MD, FACS
Hollywood Plastic Surgeon

Procedure to Volumize cheeks and Angulate Neckline

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If you want to have Voluma and a lower facelift, I would recommend having the Voluma first.  The new rule in facial plastic surgery is to "lift and fill" the face.  The face not only sags overtime but it loses volume.  If you are going to have a lower facelift, I would recommend you use your own natural fat to volumize your face with facial fat grafting.   During this procedure, volume can be added to your cheeks and face during the lower facelift.  This has the advantage of 1 procedure and your own fat to volumize will last much longer than Voluma.  

I hope this helps.  

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.