Pulling effect across cheekbones following deep plane facelift, options?

Question

Hi, I had a deep plane facelift 6 months ago and had hoped that the pulling effect across my cheekbones would disappear, but it continue to be present. When I smile, the pulling causes a downward direction ripple effect (ie the skin doesn't sit flat) and the apple of my cheeks seem to sit quite low. I've considered filler, but am not sure it would help because it feels quite taut across my cheekbones and I can't help feeling that it would flatten any filler anyway.

Min Hee Ryu, MD · Answer

Hi. Thank you for sharing your inquiry.
Based on the photos you’ve shared, it’s difficult to make a precise assessment at this time. If you could provide pre-surgery photos with the same expression, it might be able to offer a more detailed diagnosis and suggest appropriate treatment options.
It’s important to understand that all cosmetic surgeries focus on improving the appearance when the face is at rest, rather than addressing functional concerns or expressions. Each person’s face has a unique combination of facial muscles, their directions, and the tone required for movement. Therefore, achieving perfection in appearance improvement while smiling or expressing emotions can be challenging.
If the wrinkles bother you when making expressions, you might consider trying Botox treatments as a first step for improvement.
I hope this response provides some insight
Thank you.
-Dr. Min-Hee Ryu M.DDeep Plane Facelift

Lucian Ion, FRCS · Answer

Thank you for your question and for sharing your photograph.

It is fair to say that the final result for a deep plane facelift sometimes takes longer than six months, and you may notice additional changes in the coming six months. If you would like to take action sooner, it is possible to consider fat transfer, which would not be displaced by the local pressure in the tissues and can be injected more superficially.

Unlike hyaluronic filler, which would need to be positioned deeper, the non-surgical alternative would be Sculptra, which works by enhancing the collagen volume in your superficial layer and, therefore, again would not be displaced by the local tissues.

It would be worthwhile to have this conversation with your surgeon, as they are familiar with the technique they used and the details of your tissues and the tensions generated during the surgery, and they can guide you regarding possible solutions.

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