Can I have a mid face lift and remove cheek implants or should I let my face heal after the removal before having a lift?

Question

I month post cheek implant and I really don't like them. I know I should wait at least 3 months before removing them. Can I have a mid face lift at the same time of removal or should I let my face heal after the removal for 6-12 months before having a lift? I just rather not go under the knife more then I have to.I know I will hate them even after 1 year. This has made me very depressed . please advise me what to do. Am very scared and in the dark

Jed H. Horowitz, MD, FACS · Answer

Hello lella
It is best to wait for the final result before doing anything, I would advice you schedule a consultation with a board certified plastic surgeon.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants (cheek implants, chin implants and lip implants), liposuction and/or facelifts for over 30 years.  Yes, it's best to allow the cheek tissues to heal from the cheek implant surgery before having another procedure in the same area...which is what a cheek implant removal would entail.
 Having said that, it would be helpful to know some additional information.  What's the cheek implant material, style, shape and size; your height; how were the cheek implants placed...through the mouth (preferred route), lower eyelids, temple incision?  Non smiling resting photos of your face as it appears now and pre-op would also help in the evaluation.
 Here's the rationale that I have used over the past 30 years when evaluating situations such as yours.  If a reasonable shape/size cheek implant was placed in the proper aesthetic position...it's best to stick it out for another 2 months and allow the cheek tissues to heal.  This also gives you time to see the final results.  Cheek implant surgery has a wide range of post op swelling that is directly proportional to the experience of the cheek implant surgeon.  If despite all of that, you still want the cheek implant removed the tissues will be healed (less stiff) allowing the implants to be more easily removed.
 If, on the other hand, the implants are very large, thick or placed in a less than ideal manner making your face look un-attractive..then an exception can be made and the implants removed sooner.  The cheeks can be accurate and aesthetically shaped using precise placement of a dermal filler at the same time.  The minimally, invasive, SMAS facelift may also be able to be performed at the same time if you are a suitable candidate.
 Similarly, if and when to do any type of facelift would depend on what needs to be done.  Does your mid face have excess fat, flat or concave cheek bones?  Do jowls exist in the lower face, is your chin weak or is there excess fat and skin under the chin?  As described below, these all should taken into account in order to properly shape your face during the facelift procedure.
 The reality is, there are many different ways to perform a facelift from incision length, incision placement, level of tissue dissection (skin only, SMAS, Deep Plane, Subperiosteal), different degrees of tissue undermining, how to lift and support (imbrication versus plication of the SMAS layer), how much excess skin to trim, is excess fat going to be reduced and finally will the overall shape of the face be made more feminine or masculine (while avoiding the over pulled, windswept appearance).  Price is determined by the reputation, location and experience of the Facelift Surgeon.
 In my humble opinion however, there are some basic requirements that must be met in order for a facelift to be "effective", yielding "aesthetic pleasing" and "naturally attractive" results.  These include: 
 1. Some type of incision either curved around the front (preferred) or straight in front of the ear.  This is how excess skin is removed which is not possible with an incision behind the ear alone.  If you have so little excess skin on the face that "none" needs to be removed you are not a candidate for a facelift in the first place.
2. The facelift must address correction and softening of the "jowls" using a long lasting and effective technique.  If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
3. Facial shaping must be combined to properly shape the cheeks, chin, jaw line and lips for feminizing or masculinizing the face as the case may be.
 In my experience, this is the "key" factor in making the face soft, feminine and naturally beautiful.  An essential part of any facelift on a woman.  Conversely, men look chiseled and handsome when angularity is created in the cheeks, chin and mandibular angles.  The ability to provide precise, facial shaping separately or in combination with a facelift is in my humble opinion the definition of a "facial shaping expert".
 Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  If the cheeks are either flat or concave in the front, cheek augmentation with a dermal filler or using silastic cheek implants (permanent enhancement) can create full, round cheeks that will feminize the entire face.
 A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.  I have found placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.
 If you have "jowls” these are sagging facial tissues and the main indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
 My most popular SMAS facelift is the minimally invasive, short incision SMAS facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
proper SMAS Imbrication technique
no incisions within the hair = no hair loss
excess fat can be removed from the face and neck
excess skin removed from the face and neck
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
 I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.
Hope this helps.

Can I have a mid face lift and remove cheek implants or should I let my face heal after the removal before having a lift?

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Can I have a mid face lift and remove cheek implants or should I let my face heal after the removal before having a lift?

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