Side profile issues. Would a mid face lift or cheek lift improve this problem? (Photo)

I am a 32 year old woman who has grown to dislike my side profile. Over the past 4 or 5 years it seems the tear trough area has sagged enough to cause my side profile to look "hard" and makes me look sad and/or older. Would a midface lift or cheek lift improve this problem?

Doctor Answers 26

Mid Face Lift

Hi Blaze88

It's great that you felt able to post your question and photo. It always helps our RS community as other people can see your concerns, and then may not feel like it's only their issue.

You may benefit from fillers or PRP. Definitely go see a PS and discuss the options with him/her and see what they say.

PRP is an autologous procedure that involves using the patients own blood to extract plasma and growth factor which is then injected in to the target areas. The PRP stimulates and accelerates skin regeneration and collagen production by the injections of growth factors. PRP injections can also be used in conjunction with dermal fillers if additional volume is required. PRP is selectively and carefully delivered in to specific areas with a series of injections. Before the treatment you should be assessed by an experienced medical professional to see if PRP injections are the right treatment for you. Your specialist will then be able to talk you through he procedure and inform you of what the treatment can achieve.

Filler: Wrinkles, creases and lines in these areas can be treated by filling the skin with a specially formulated gel ‘filler’. This is injected into or under the dermis (the deepest layer of the skin), pushing up and flattening the crease or wrinkle.

Lower eyelid surgery aims to address the bags under the eyes. Excess skin and removal or reshaping of the fat smooth’s the contour between the lower eyelid and the cheeks. Your cosmetic surgeon will assess if the procedure can be performed under local anaesthetic.

Voluma can help lift the cheeks back into a youthful appearance.

If volume loss in your cheeks is your main concern, you would likely benefit more from dermal fillers such as Voluma than from a surgical procedure. Voluma can help lift the cheeks back into a youthful appearance, and this can also help to disguise hollow tear troughs. I suggest visiting a board-certified facial plastic surgeon for a consultation to further examine your concerns and come up with a treatment plan, but I do not think that surgery is warranted at this point. I hope this helps.

Jonathan Kulbersh, MD
Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 66 reviews


I think your lower lid looks darker, this happens as it hollows and the light reflects differently.  This can make you look tired and that makes you feel tired.

I think cheek filler (I like Voluma best)- and tear trough filler (Restylane my favorite) Be careful filling cheeks without tear trough as in your case this might deepen the tear trough & the shadow.

Also- a brighting laser like BBL or Halo always helps!

Melanie L. Petro, MD
Birmingham Facial Plastic Surgeon
4.7 out of 5 stars 31 reviews

Cheek implants for midface volume restoration

 In our practice, we do not perform a lift of the midface or cheek area. The reason for this is that the mid face shrinks  and loses volume with the aging process, and does not vertically descend. The lateral face decends therefore, a face lift is required. To rejuvenate the midface in our practice, we used cheek  implants. Silastic s cheek implants are placed  through a intraoral approach under a brief general anesthetic as an outpatient surgical procedure. For many examples, diagrams and more information, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Mid facelift for 32 year old

Since you are 32, my recommendation is that you explore fillers or fat grafting to improve your profile.  The flatness of the front of your cheek and transition zone between the lower eyelid and upper cheek can usually be profoundly improved without surgery by using a filler such as Radiesse or Voluma (cheek), along with Belotero (lid-cheek junction and lower eyelid).  This can be done with just a bit of topical and injectable anesthetic with minimal downtime and disruption to your everyday routine.  Alternatively, or especially once you have had a round of fillers and are happy with the improvement, fat grafting (collecting your own fat from your lower abdomen or flanks and re-injecting it into the face) can be done and has more longevity and even permanence.  Best wishes! 

Alyson Wells, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 24 reviews

A 32-year-old is not a candidate for a midface lift.

At age 32 you may benefit from volume enhancement but certainly not surgery. I would also be cautious about the midface lift in the future. Make certain you have the procedure done by someone who knows what they're doing. This is a very tricky procedure that can generate lower eyelid issues.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Side profile

You might be happy with just fillers to raise the lid/cheek junction and add some fullness, and that alone can be quite rejuvenating. Fat transfer and cheek implants (not as common these days) are also options. See a surgeon that can offer you the full range of options and start where you feel comfortable. Fillers are a great starting place.

Stacey Folk, MD
Denver Plastic Surgeon
4.8 out of 5 stars 24 reviews

Improving My Profile

A frontal view would be helpful, but augmentation of your cheeks and the tear troughs will probably be the treatment of choice. Cheek projection and contour can be improve with injections of long acting fillers such as Voluma or Restylane Lyft, fat injections, or cheek implants. Consult with a surgeon who uses all of these techniques. The tear troughs can be filled with fat or fillers.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

You should consider fillers

Neither cheek lift nor midfacelift will accomplish your goal. Nothing will accomplish your goal completely. However you will benefit from fillers like Radiesse and Voluma.  

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

Side profile issues. Would a mid face lift or cheek lift improve this problem?

  Hi, I have performed many facelifts over the past 30 years, a significant umber of these on women in their late twenties and early thirties that had early jowl formation.  From the attached photos, the cheeks are flat anteriorly (in the front), the chin is weak, there is a slight amount of excess facial and neck fat along with excess facial skin evidenced by jowls and nasolabial folds. These combine to create a rectangular shaped face.

  Following the beauty principles outlined in my book on face and body beauty, 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.  Cheek augmentation using a dermal filler (I prefer Restylane Lyft) or with cheek implants for a permanent enhancement will create full, round cheeks anteriorly that will feminize the entire face.

  When the chin is very weak, this creates an imbalance making the nose appear larger, the lower face short and the mid face appear top heavy while de-emphasizing the lips and allowing early "double chin" formation. Chin augmentation, using a chin implant, will add projection to the chin creating harmony and balance to the lower face.  I have found placing a silastic chin implant through a small, curved, incisions under the chin to be very safe, quick, highly effective and far less invasive than a sliding genioplasty that requires bone cuts with placement of screws and metal plates.

 owls are sagging facial tissues and an indication for some form of a SMAS facelift. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured.  The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane and subperiosteal facelifts) but with these added benefits:

•very small incisions
•minimal tissue dissection = less bruising and swelling = rapid recovery
•can be performed in 90 minutes or less, with or without anesthesia
•no incisions within the hair = no hair loss
•excess fat can be removed
•excess skin removed
•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 tell potential facelift patients to think of creating a more beautiful or handsome face by working on three tissue levels.  The bony structure should be appropriate to make a woman’s face heart shaped and a man’s face chiseled and angular which is described below.  Next the fatty layer should be reduced or shaped allowing the shape to be seen and finally excess SMAS and skin evidenced by the presence of jowls) should be removed from the face and neck.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

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.