Cheek implants or midface lift? (Photos)

Question

I have acne scars on the soft tissue of my cheeks that I have had treated with multiple laser, microdermabrasion, chemical peel, and IPL treatments. I have also had a number of different fillers added to my cheeks and eye trough to help lift the tissue, which significantly helps smooth out the tissue below it. I would like to achieve a similar effect that is longer lasting. Would cheek implants or a midface lift be the better option achieve this?

Robert M. Tornambe, MD · Answer

miatortilla.  Better photographs would be helpful, however it appears you do have options. One option may be just fat transfer to your mid-face and cheeks.  Another option may be a MACS Mini-Facelift with or without fat grafting. This would address modest redundant skin of your neck as well. Be certain to consult with a board-certified plastic surgeon. Best of luck.

Jason Emer, MD · Answer

FaceTite can internally tighten the skin in the lower face and neck. After all the skin has been heated and contracted, we shape the neck with liposuction to give definition and remove stubborn pockets of fat. In one quick treatment, we can tighten skin, remove fat, and contour the lower face, jawline, and jowls with only a weekend of downtime.​  Keep in mind that combination approaches will give you a more significant improvement as opposed to a single procedure. I recommend getting a consultation with a board-certified cosmetic dermatologist and facial sculpting expert. Best, Dr. Emer

Jonathan Kulbersh, MD · Answer

You’d probably be happiest with a midface lift with or without a neck lift, as you have some excess skin on the neckline, too. Cheek implants will create a little lift as well, but won’t do as much to address your neck. I’d suggest finding an expert facial plastic surgeon whom you trust for an in-person evaluation. Then you can come up with a plan together. My office is in Charlotte, so feel free to call or even arrange for a Skype consultation. I hope this helps.

Philip S. Schoenfeld, MD, FACS · Answer

You are asking a good question.  If you have added filler to your cheeks in the past to fill out the face and provide volume, I am not certain that a midface lift is going to give you the volume that you are hoping for in your midface in order to decrease the appearance of acne scarring.  In this case a consult with someone experienced in fillers and fat injections, midface lifting, and placement of cheek implants would be a good idea and they should be able to tell you the pros and cons of each approach.

Houtan Chaboki, MD · Answer

Cheek implant surgery is an option instead of fillers for lifting the mid face. It's a relatively minor procedure with minimal discomfort. However, the initial swelling is more as compared to filler treatment.  Read our blog post on implant vs. filler. Patients who want cheek advancement may or may not benefit from a mini lift, which is more for the lower face and neck. Lastly, other than an implant, fat transfer is another option that can provide long lasting results. An evaluation by a plastic surgeon can help determine appropriate options.Best,Dr. Chaboki

John Michael Thomassen, MD · Answer

A facelift with a SMAS lift is a nice option that will give you natural results with a relatively quick recovery.  Cheek implants can look unnatural and result in asymmetry as well as prolonged recovery.  You do not appear to have a paucity of volume that would make a cheek implant the better option.

Zoran Potparic, MD · Answer

It is very hard to give you good recommendation based on these photos. In general it looks like shaping and augmentation of the cheeks with fat grafting will improve midface better then lift. In addition aggressive dermabrasion (with diamond burr) and chemical peel(s) in stages may improve your skin quality, scars and dis-pigmentation. In person evaluation by a board certified plastic surgeon with good reputation in facial rejuvenation is recommended. Good luck.

Sean Freeman, MD · Answer

miatortilla, no one can give you a good answer to your questions without the benefit of an exam. See an experienced plastic surgeon that specializes in "only faces" and has great photos. See the video and good luck!

John J. Bandeian, MD · Answer

You have blurred out too much of the pictures for me to be able to answer your question. You did not mention what type of fillers  you had, but if you have not had a long lasting filler, you might consider that as another option.

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

I have performed many facial shaping procedures over the past 30 years using dermal fillers, silastic implants (cheeks, chin, lips), liposuction and facelifts.  Many of these have been SMAS face and neck lifts and for over the 15 years I have performed many minimally, invasive SMAS facelifts because of the many benefits this particular procedure offers.   Your question in my humble opinion has two separate parts.  First, there's the issue of adding volume to the cheeks and mid face.  In that regard, 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.  Your cheeks are concave in the front (the left more so than the right).  With concave or flat cheeks in the front, cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face. The second part of your questions concerns the appearance of the acne scarring over the cheeks and mid face.  I have performed many cheek augmentations using silastic implants.  It's an "urban myth" that implants will lift or stretch out the overlying skin of the cheeks.  In reality the implant is placed on top of the bone under a strong tissue covering called the periosteum.  This helps secure the implant on the cheek bone but means that it is "not" in direct communication with the soft tissue and skin layers above the implant.  So unless a "huge" implant is placed which would aesthetically distort the cheeks, the implant will not stretch out the skin. There is another solution however, to this issue.  Facelifts have been used for many decades as a tool to remove skin from the face thereby stretching the skin which in turns decreases the depth (and therefore the appearance) of acnes scars over the face.  This can be done on patients at an early age that do show the typical signs of facial aging, called "jowls" as a specific measure to improve the appearance of acne scarring of the face.  Often, this is performed prior to any skin resurfacing laser treatment as the facelift will result in a more "shallow" acne scar(s) per area.  This means the laser doesn't have to go as deep which in turns means less recovery, healing time, skin color issues along with fewer unwanted side effects and complications.  The facelift is performed first followed by the full face laser typically 1 year later (allows for full return of blood supply to the skin of the face).
  Below is a description of a minimally, invasive SMAS facelift that could be used to accomplish this goal.   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
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.

Cheek implants or midface lift? (Photos)

Answers (10)

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