What can a plastic surgeon do to prevent ectropion resulting from a vertical cheek lift (lower eyelid incision)?
Doctor Answers 2
Thrue cheek lift
It is possible to achieve permanent cheek lift providing that one can anchor lifted tissue in a stable position. This is in our practice achieved by drilling 2-3 small holes along lower orbital rim and using it to anchor cheek/malar pad. This provides more skin to the lower lid and prevents ectropion. Additional procedures such as lower blepharoplasty (conservative removal of lower eyelid skin, if necessary) and canthopexy (to tighten the eyelid) are done in the same time. Consultation with an experienced board certified plastic surgeon with extensive experience in facial reanimation and periorbital/eyelid surgery to discuss your goals and options would help.
Facelift that goes deeper into the facial tissue plus fat transfer is known for its lasting effect
Malar fat pads are best addressed by SMAS and deep plane lift--in layman's term, we must go deeper beyond the skin. Skin lift is an antiquated technique that great surgeons have long abandoned due to its short-lived result, unnatural appearance (flatness of the cheek and overly tight appearance), and poor scarring.
I also typically combine facelift with fat transfer to hide the laugh lines and create a smooth transition between the lower lid and upper cheek. The truth is, fat transfer is a highly flexible and useful procedure as it can also correct the appearance of pre-jowl sulcus (the sagging tissue adjacent to the chin and along the jawline) and the depression of the temple.
Simply put, long-lasting and natural results (average of 12-15 years) are achieved when we go deeper into the facial muscle and tissue and at the same time address facial volume loss preferably with the most natural material--your own fat.
Good luck and best wishes.
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