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.