Age 30. Is the only way I can address heavy cheek tissue with a facelift? (photo)

Question

Hello, I am a 30 year old woman who has had hereditary, heavy cheek tissue her whole life. It has started to sag and worsen my nasolabial lines and my mid-face. I am under weight and have tried multiple treatments like buccal fat removal, threadlifts and filler - none of which have helped to address my issue. Is my only option to get a facelift either endoscopic mid-face lift, high SMAS cheek lift, sub perioral mid-face lift or another type?

Guray Yesiladali, MD, FEBOPRAS · Answer

Thank you for sharing your experience. Based on your description, the concern appears to be hereditary midface heaviness and sagging, which is now contributing to deepened nasolabial folds and midface descent.
In many such cases&mdash;especially when the tissue is genetically dense and previous treatments like buccal fat removal, thread lifts, and fillers have not provided lasting improvement&mdash;the most effective solution tends to be surgical.
Among the options you mentioned, a midface lift is typically the most targeted and appropriate procedure. 
The exact technique would depend on your facial anatomy and surgeon’s preference, but based on your history and presentation, midface lifting is often the definitive path forward when nonsurgical methods have been exhausted.
Warm regards,Op. Dr. Güray YeşiladalıBoard-Certified Plastic Surgeon

Ali Riza Öreroglu, MD · Answer

Based on the photos you’ve provided, you appear to be a suitable candidate for a lower facelift. However, to determine the most appropriate treatment plan, a physical examination is necessary.  A lower facelift addresses sagging in the jawline and neck area, also improving the mid-face and offering a more youthful appearance. This surgery can help reduce the prominence of nasolabial folds and achieve a more defined, rejuvenated look. A thorough evaluation will be required to fin

David K. Isaacs, MD, FACS · Answer

You will hear people saying “30s is not too young for a facelift….” That might be true in a minuscule number of patients, but it’s extremely rare. Most having it done are way too young, do not need it, and the changes, when you see a change because most you don’t, are typically unnatural.  
I would not perform a facelift (I don’t care what approach), nor would I perform threadlifts, nor would I perform filler. You can maybe benefit from an anterior neck lift but I’d obviously want to see you in-person.

You’ll find someone to sign you up. So get several honest opinions.

And remember, sometimes less is more.

Consult an expert for an evaluation. Hope this helps!

Michelle Zweifler, MD · Answer

In younger patients with sagging cheeks, I would offer first Sofwave nonsurgical skin tightening device.  Previous cheek filler should be dissolved.  A cheek lift or mini-facelift will lift and restore cheek contour plus soften the nasolabial fold.   With endoscopic subperiosteal facelifts there tends to be prolonged swelling.

Lily Daniali, MD · Answer

First of all you have beautiful skin and excellent skin quality. You stated that you have hereditary heavy cheeks, and you are starting to see deepening of your NL folds. It is possible that your use of fillers in your cheeks is heading to worsening of the weight in your cheeks. HA fillers are like sponges and can hold on to fluid while also migrating through the soft tissues. You may consider having your fillers dissolved to see if that unweights your cheeks. Deep plane face lifting approaches are very powerful and allow for direct contouring of the soft tissues, tightening of the fascial system of the face and neck. You are a younger patient, and it is a personal decision if you are ready for this approach this early on. I would counsel considering investing first in non-surgical tightening with Sofwave to stimulate collagen and elastin after dissolving out your fillers. If you still want more at that point, you can feel comfortable pursuing facelifting procedures with an experienced surgeon in these techniques. Many facelift surgeon will want the fillers dissolved out before surgery too. You may be surprised how much slimmer your face is after removing fillers that may be causing cheek distortion.

Diana Marquez, MD · Answer

We would suggest for you polylactic acid in a vectorial fashion way to create tension.We feel you are still young for facelift.We hope this helps you.

Age 30. Is the only way I can address heavy cheek tissue with a facelift? (photo)

Answers (6)

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