What type of face lift do I need? (Photo)

Question

Hello so over the years my cheeks sagged a lot, giving me wrinkles, I have no saggy chin but only big nasolabial folds due to cheeks sagging, what type of facelift do I need for the cheeks to look like before, no more wrinkles ? Thank you

Michael I. Echavez, MD · Answer

Looking at your pictures, I would say that you do not need a facelift.  The main reason that you have prominent nasolabial folds is due to loss of volume above that area in your cheeks.  Adding volume to your face between your eyes and your nasolabial folds would help to rejuvenate your face and improve the nasolabial folds.

Myung Ju Lee, MD, PhD · Answer

There are many different types of facelift and its' techniques. While there are many different non-surgicals and surgical methods, I would like to recommend extended deep plane facelift for a long lasting result. Extended deep plane facelift effectively pulls the anterior part of the loosen skin on the front cheek. This is effective to the concerned areas. I would recommend you to have a thorough consultation to better understand what to expect after your surgery. Thank you.

Donald Groves, MD · Answer

Unfortunately, it is difficult to answer your questions without having a formal discussion with you of your specific surgical goals and a formal physical exam. Let me help give you some more information though. The main factors involved in facial aging are:.1. increasing skin laxity2. relative descent of some deeper facial structures (e.g. fat pads)3. loss of facial fat and bone density- this combined with the first 2 factors results in hollowing and other characteristic appearances of an aging face. A facelift or mini-facelift helps with skin tightening (by surgical removal of excess skin), but also allow for adjustments to some of the deeper face structures- e.g. tightening of the SMAS layer, simultaneous fat grafting to certain areas to replenish the volume lost with aging. Also, if you have prominent jowling, significant neck skin laxity, or banding in your neck, these are best addressed with some type of facelift. Fat grafting adds volume to specific areas of your face by taking the fat from your abdomen or thighs, and injecting it into your face. This is your body's own natural tissue, so you don't have to worry about rejection or reactions to the injected material. Once the fat "takes" (lives and integrates into the new injected site), the results last a long time.. With all that said, there is limited information that can be gained from the photos you have provided. I would urge you to arrange a formal consultation with one or multiple plastic surgeons to really discuss your surgical goals, be formally examined, discuss all your options, and decide on the best procedure(s) for your specific case. I hope this helps! . Best, Dr. Donald Groves Plastic Surgeon

Ned Snyder, IV, MD · Answer

Thank you for submitting your questions/photos.  There are several options for improving the contour of the mid-face and nasolabial folds.  Based on your photos, you may be a good candidate for EuroThreads.  This is a minimally invasive procedure that can help elevate the mid-face, giving it a smoother contour and also minimizing the NLF.  Of course, I’d recommend you see a board certified plastic surgeon in person to go over your options in more detail.  Good luck and thanks again for reaching out!

Mark G. Albert, MD, FACS · Answer

Hello,
Thank you for your question. Based on your photos, a deep plane facelift is a great option to lift the midface as you are simulating in the 3rd photo. This can be done wide awake using local anesthesia and oral medications to help you relax. Patients do incredibly well with this and it avoids the side effects of general anesthesia.
Mark G. Albert, M.D., F.A.C.S.New York, NY

Richard G. Schwartz, MD · Answer

Your photo shows flattening or atrophy of the upper mid cheeks, which leads to loosening of the mid cheek tissue and downward sagging of cheek skin and fat.  Hence the deepening of nasolabial folds.  A cheeklift should remove and tighten cheek skin and fat, smoothing the folds and repositioning some of the fat up to the mid cheek to fill in the depression there.  If you wanted to avoid surgery, using either fillers or your own fat to increase volume of the mid cheek and nasolabial fold would also lift the mid cheek slightly and soften the folds.

Michelle Copeland, MD, DMD · Answer

Thank you for your photos! Thanks to the advent of new technologies we can do a lot less and achieve more positive, natural-looking results. With a mini-lift, only the lower face-- from cheek to chin-- is lifted, which effectively eliminates jowls and redefines the cheekbones. As with a face-lift, the mini- lift is often accompanied by a neck lift, which removes fat from below the chin and tightens the neck's platysma muscles, all though a tiny incision under the chin. The best candidates for the mini-lift are those who are unhappy with the contour of their lower face and neck, and whose skin has good resiliency. I suggest making an appointment with a board-certified plastic surgeon to discuss your options.

David M. Creech, MD · Answer

The Midface (central face) is the primary area of the face that other people look at during conversations.The procedure I use to improve this area is a midface lift. The procedure involves doing the lower blepharoplasty and then lifting the entire cheek area up. This diminishes the nasolabial folds and restores the natural fullness over your cheek bones and gives you a rested appearance.

Connie Hiers, MD, FACS · Answer

Although pulling your face back might give you a look you like, it is really not realistic. You can get improvement with noninvasive micro-needling with radiofrequency like Secret, or even a mini facelift. Go meet with a board-certified facial plastic surgeon and discuss your concerns and options.

David Tuggle, DDS · Answer

Greetings, as we age we loose volume in our midface. From your photos I would consider maybe cheek filler or cheek implants to give more support, that might eliminate or reduce the folds, also much less downtime than a face lift. I do an S-Lift for these as well (we call it a mini-lift at our office because it doesn't involve opening the neck at the midline. You may be happy with some of those conservative treatments first.

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