What Works to Tighten Sagging Skin on Your Cheeks?

There are many ways to reduce the appearance of wrinkles on the skin.
If the patient is looking for a temporarily or minimal solution, light peels, Juvederm, radiofrequency devices, etc wil help somewhat. We have been discouraged by the string and ribbon lifts as they seem to have very limited longevity.
For patients wanting to obtain a more permanent result, a facelift will tighten lateral cheek skin best. If a volume enhancing facelift is performed, especially with SMAS elevation and LiveFill (nonaspirated fascial fat grafts), even better.
For areas below the eyes into the cheeks (the midface), a facelift is usually a weak option, and the patient may wish to consider midface elevation with a cheeklift of some type. There are several articles in our Mathes Plastic Surgery textbook chapter and Plastic and Reconstructive Surgery journal articles which highlight some of the current techniques. http://www.drbrent.com/article_mathes.php
When a cheeklift is performed, the tissue of the midface (area below the eyes) can be lifted in a subtle fashion, tightening the skin. This is not the same as performing a blepharoplasty and removing skin, since that can pull down on the eyelid and change its shape to drooping or round. Our most advanced cheeklift lifts also restore volume to the lower eyelid (LUSIC cheeklift) with LiveFill, or fascial fat grafts obtained from the patient. It is important to preserve the shape of the lower eyelid. It is also important to restore lost volume whenever possible.
If the facial shape warrants it, a cheek implant may also be considered. I usually reserve this option for patients who need three dimensional augmentation in the malar or submalar regions, not just to combat aging, although this is a controversial area even among excellent surgeons!
Last, conservative CO2 laser resurfacing helps to tighten the skin further, and reduce surface sun damage and wrinkles.

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

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

Dear Triss,
Of course the standard surgical facelift gives the longest results but is expensive and carries more risks than the quick fixes. Most people prefer a quick easy safe procedure which is done under local anesthesia and gets you back to work in a few of days. This describes the Silhouette/Ribbon Lifts which are threads and devices which are easily slipped under the skin to raise up the sagging skin. They can last up to 3-5 yrs and cost roughly $3500-5000.
Other adjunctive procedures like fat injections or various fillers can supplement the Lifts quite nicely and are recommended as well but don't give as nice of results by themselves. I like to combine them and also most patients benefit from a medium depth TCA chemical peel which can be done at the same time for an additional cost of roughly $1000 for the peel.

It depends on how much laxity you have; I’d love to see a picture to give you a better recommendation; if its too much, I suggest going see a plastic surgeon and get a facelift, but if, on the other hand, there is not much saggy skin, there are other treatments to get that aren’t invasive such as Ultatherapy which lifts and tightens your skin giving you a better-refreshed look; I also suggest getting different sessions of Thermage or FaceTite which is a radiofrequency that improves the production of collagen giving you a better elasticity, tightening and lifting of the skin. All of these treatments, combined with CO2 and Erbium lasers, give you excellent results.

Depending on your age you can consider a surgical procedure to reduce and tighten skin or consider using new technology involving radiofrequency energy to tighten your facial skin.

Thank you for your question. I would suggest Ultherapy for facial skin tightening. Ultherapy deposits focused ultrasound energy below the surface of the skin to stimulate the body’s creation of new collagen. As a result, skin will actually begin to lift and tone over time. Collagen is a natural protein that gives skin its youthfulness by keeping it firmed, toned and elastic. Plus, the treatment is completely non-invasive and does not require downtime. I have seen excellent results with the treatment.

Surgery of course will tighten sagging skin on your cheeks.  Also, a treatment called Ultherapy targets underneath the layer of the skin to tighten in a non-invasive and less expensive way. It creates lift whereas lasers work on the surface of the skin. Lasers do not do much as far as cheek laxity but will improve wrinkles.

Facelifting is the most obvious answer. This can help elevate soft tissue that has fallen and take up extra skin. There are some lasers that can tighten the skin, but in my hands they only give about a 20% improvement. The advantage to the lasers are that they result in very little down time and are ideal for the patient with only mild laxity and who doesn't want to undergo a facelift. Facial skin laxity can also be the result of "deflation" or the face or facial fat atrophy. Soft tissue fillers can plump the face to fill it out a bit. This can be done in conjunction with all the other techniques that I have described.

There are many options for sagging cheeks. If the problem is a volume issue, fat transfer from the abdomen or thighs can be a good option. This is a permanent solution but can take a time or two to get the desired result. For a quicker fix, artificial cheek implants are a good option. If you do not like the result, removal is easy and you are back to where you started.
If skin laxity is a concern, a midface lift may be your solution. This helps to lift and tighten sagging tissues. Ablative laser treatments can help to decrease wrinkles as well.
To determine which is the best option, consultation with an experienced surgeon is your best option.
Good luck.