Will a cheek lift be permanent or sag over time?

Question

I've heard of doctors putting in cheek implants, and reattaching the cheek muscle higher on the cheek bone under the implant. I'm guessing this 'reattachment' of the cheek muscle to a higher position on the cheek bone is a cheek lift? Is this reattachment of the muscle permanent? Or does the muscle sag/ stretch back to original position after a period of time? If one was to get just a cheek lift (no implant), would this be permanent? Thanks!

Randal Haworth, MD, FACS · Answer

Cheek lifts have many synonyms including subperiosteal midface lifts, vertical lifts and endoscopic made facelifts. They are performed either through incisions in the hair of the temple, or through the lower eyelid.  I have  abandoned  the lower eyelid  incision approach  since it's associated with more complications  including  lower eyelid retraction ( droop ). I also employ incisions inside the mouth. I have patients who still display dramatically improved appearances 12 years after the original midface lift.Therefore, to answer your question, it is essentially permanent.  However, as I tell all my patients, plastic surgery reverses time but time still marches on.

Jason Emer, MD · Answer

Facial sculpting and contouring can be created with well-placed fillers (Voluma, Countour, Radiesse, Bellafill) and Sculptra, which would give improvement in facial balance. Fat or implants are alternatives. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Jed H. Horowitz, MD, FACS · Answer

Hello julyCheek implants are available in a range of different shapes and sizes, they are mostly customized to fit a specific facial structure. Fillers such as Juvederm Voluma, Radiesse and RestylaneLyft are great alternatives to cheek implants, also fat transfer or injection can be done.

Mario S. Yco, MD, FACS · Answer

There are no muscles in the cheek that are detached and re-attached in a cheek lift (also known as a midface lift). The malar (cheek) fat pad is, however, lifted and suspended over the implant. The implant is placed on the maxillary bone and over part of the masseter muscle. Manipulating any of the facial muscles of expression in the cheek can cause significant complications such as facial weakness or a crooked smile.

Jan Zemplenyi, MD · Answer

Hi July,There
are several options that can be considered to improve the cheek area, depending
on whether one wants a permanent or a temporary effect.  Cheek implants are a permanent procedure,
taking about 45 minutes in the hands of an experienced cosmetic surgeon, under
local anaesthesia.  Most swelling
dissipates after 10 days and complications are rare. There is the Non-Surgical Cheek Lift with
fillers which
can be done in a few short minutes with minimal downtime and minimal risk. Fat injections can also
accomplish cheek augmentation. Fat is harvested from your thighs or abdomen and
is specially treated to separate out the pure fat cells. This is then injected
into areas of need in your face, which can include the cheeks, eyelids, jaw
line, forehead, and temples. Results can last from 4 months to more than a year. As for the Cheek Lift you asked
about, this is a surgical procedure that elevates the midface up towards the eye and out
toward the temple. This repositions a saggy cheek back over the cheekbone by
lifting the soft tissues upwards; results are not permanent.  Among these procedures, the cheek implant
would provide results that are permanent.

Ernest Robinson, MD · Answer

A cheek implant is any material, usually silicone or temporary filler, placed in the cheek bone (malar) region.  If a solid silicone implant is used it may be placed intraorally, via the eyelids or uncommonly from a facelift approach.  The implants can be removed.Temporary fillers are placed with a needle, sharp or blunt, usually from over the region to be augmented or intraorally.  Fat can also be used.A cheek lift  is a movement of the cheek to a higher position.  The incisions can be placed in the eyelids, intraorally and from the temple regions.  A combination of approaches can be used.  This should offer long term benefits.An elevation and suspension, rather than a "detachment of muscles", is the goal with cheek lifting.  Some surgeons combine solid implants with a cheek lift.

William Portuese, MD · Answer

Cheek implants are placed for patients  who have a flat maxilla and a flat cheek profile. Cheek implants are composed of Silastic, and are manufactured in a large variety of sizes and shapes. The implants themselves are placed through an intra-oral approach underneath the muscle and underneath the periosteum directly over the maxillary bone. The procedures usually performed under a brief general anesthesia as an outpatient surgical procedure. For many examples and more information including diagrams of the  different implants, please see the video and the link below

William Marshall Guy, MD · Answer

Hello July1990,Your question regarding cheek implants and cheek lifting are really two separate questions.  WHenever an implant is placed in the body, that implant is permanent (unless you choose to have it removed).  So 20 years from now the implant will still be in place and doing its job.  However, the tissue around the implant will continue to age, sag, and droop.  This can be a problem with cheek implants because they can become more visible as time goes on since the implant doesn't droop.  As far as a cheek lift, this is more than what traditionally occurs at the time of a cheek implant.  With a lift, the tissue that is sagging in the cheeks is lifted and attached back to where it used to be, and the excess skin is removed.  This result is permanent because the skin that is removed will always be gone, and the tissue that is lifted will always look better than if surgery hadn't been performed.  But after surgery, gravity and aging will continue and the skin will stretch and tissues sag with time.  So 10-15 years post operatively you may have the same appearance you did preoperatively, but this appearance is still more youthful than if you hadn't had surgery before.I'd recommend you consult with a facial plastic surgeon to go over your options and see waht is best for you.  I hope this helps and good luck.

Andrew Kaczynski, MD (retired) · Answer

In your question you have combined two different procedures: cheek implants and she could lift. These are rarely done together.  Cheek implants are indicated for people that have very flat faces and essentially no cheekbones. Permanent implants are placed usually through the mouth over the cheek prominence. The implants are solid silicone and give a permanent result.  Very few people are actually candidate for this procedure.  A cheek lift is actually lifting up the skin and the muscle of the cheek without doing any substantial work in the neck. It is essentially the upper half of a standard facelift. The cheek lift may be combined with Liposuction or fat grafting in the mid cheek or  jowl area. The results  from a cheek lift usually last 7 to 10 years.  There are also mid facelifts which are often done through the eyelids and lilf the lower lid and cheek up in a vertical position. Very few people do these as the complication rate is extremely high. Your best option is to see a board-certified plastic surgeon who is experienced in facial plastic surgery and discuss your concerns

Francis R. Palmer, III, MD (retired) · Answer

Hi, non smiling photos of your face from the front and side would help in the evaluation. I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts. Following the beauty principles outlined in my book on face and body beauty, 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.  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. Augmenting the cheek is far more reliable a method of creating an aesthetically shaped cheek the any type of lift...none of which are permanent. Cheek implants do however provide a permanent enhancement to the cheek. For those reasons, I prefer to perform an appropriate SMAS type facelift and supplement that lift with cheek augmentation for the "best" of both worlds and the most aesthetic facial improvement.  If you have "jowls” these are sagging facial tissues and an 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 facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits:very small incisionsminimal tissue dissection = less bruising and swelling = rapid recoverycan be performed in 90 minutes or less, with or without general anesthesiano incisions within the hair = no hair lossexcess fat can be removedexcess skin removedcheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implantsmost patients fly back home to parts all over the world in as little as 3 days post-opI 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.

Will a cheek lift be permanent or sag over time?

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