Age 27, which is the best cheek lift technique to restore natural position of fat pads? (Photos)

Question

Hello, I'm 27 yet have hollowing of the eyes, flattening and sagging of the cheeks. Therefore, am seeking a mid-face lift to restore the natural position of the fat pads, fascia etc on the cheek bone. I’m wondering which is considered the better technique – an incision via the lower eyelid or endoscopically through the temple? I do have excess fat and skin in the lower lid but am scared this technique would change the shape of the eye. Thank you very much for any insight!

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your questions and posting your photos. It appears that your cheek has fallen a bit, there is some fat prolapse and an apparent tear trough. You probably need a lower eyelid blepharoplasty with fat repositioning and cheek elevation. Dr. Jeff Schiller is the best I’ve seen at this technique. I hope this helps. 
Good luck!

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Nelson Lee Novick, MD · Answer

You're very young. Surgical facelifts are expensive, aggressive, invasive, and engender significant post operative downtime and healing, risks potential scars and other complications, and are usually reserved for considerably older individuals with substantially more laxity in the skin envelope than appears to be the case in the photos provided. The upper cheek region is a major support area for the infraorbital (under eye) region. Volume deficit or loss in this area can lead to the development of under-eye tear troughs, hollows and bags. This same region is also important for facial contour. When there is volume deficit or loss, particularly in the upper outer cheek fad pad, the female face can lose its much desired oval, heart-shaped appearance. So, restoration of the volume in this critical area via the use of an appropriately robust HA filler properly injected by an experienced injector can not only restore the more ideal contour of the female face, but secondarily improve the under-eye region. The results of this filler approach are typically immediate and evoke an immediate "Wow!" reaction. You would be wise to consult with a board certified cosmetic dermatologist before jumping into surgery and best of luck.

Gerald Wittenberg, MSc, DMD (retired) · Answer

The answer really depends upon the 'vector' of the lifting. The lower lid approach lifts the cheek pad vertically which is normally the most ideal. The temple lifts it laterally. However, the  final appearance will also depend upon the strength of the 'cheekbone'. For example, a cheek implant/augmentation will lift the youthful soft tissue and help balance a cheekpad which has fullness due to the lack of bone/cheekbone support. Talk to the surgeon about your anatomy for the best decision

Age 27, which is the best cheek lift technique to restore natural position of fat pads? (Photos)

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