What Are the Options for Sagging Cheeks Other Than a Facelift?

An Endoscopic Midfacelift with endotine fixation is an attractive alternative to the traditional facelift procedure to rejuvenate sagging cheeks.  The Endoscopic Midfacelift elevates and replaces the soft tissues of the cheek and midface to the the position they occupied in youth.  No skin is resected in this procedure, so it avoids the "wind tunnel look" that can be produced by the excessive tightness of the facial skin that can result from an aggressive facelift.

Just as importantly, the emphasis of our Endoscopic Midfacelift, is on restoring the 3-dimensional volume of the face, resulting in a softer and more naural facial contour.  The endoscopic approach allows the access incisions to be hidden behind the hairline and inside the mouth.  Finally the endotine, which is used to hold the repositioned soft tissues in place, is completely resorbed by the body within 6-9 months after the procedure, by which time a lattice of soft tissue has formed at the site of fixation that locks the surgical correction in place. Our patient satisfaction with this procedure has been very high, and because of the naturalness of the result and the well-hidden nature of the scars, i believe it represents the best alternative to a conventional facelift for rejuvenating the cheeks and midface area.

Many different options exist to improve the midface, ranging from minimally invasive to facelift surgery. As a board certified plastic surgeon, I get asked this question daily. As a general rule of thumb, the facelift is most effective. The less invasive, the less effective. Most important is to meet with each patient to determine what type of results are desired. Both males and females suffer from aging, yet I find that every patient has different needs. One person might be satisfied with a subtle improvement, while another wants a more dramatic result. In the less-invasive arena, there is microneedling with RF (radiofrequency), which can be performed with topical numbing cream. It involves treating the skin with radiofrequency to stimulate collagen formation, thereby tightening the skin. This can be combined, if need be, with dermal fillers (which are temporary) to help revolumize the sagging area. A slightly more invasive procedure would be using thread lifts to help resuspend the skin in a higher position. This is performed with a suture material that dissolves over time and has minimal downtime, and threadlifting is performed in a treatment room (not operating room since it is not a surgery). Fat transplantation can sometimes accomplish such revolumizing, and a benefit to this approach is that the fat is permanent (unlike the fillers). The gold standard is the facelift, which is the best treatment for moderate to severe sagging of the cheeks. A properly performed facelift should leave a patient looking refreshed, but not at all pulled. A natural result is key!

It’s important to realize that
facelift procedures are the gold standard for treating facial aging. These
procedures are versatile, reliable and very predictable. They can be used to
treat a wide range of anatomic deformities that are frequently associated with
facial aging.No other therapeutic
modality has the range and effectiveness of the facelift. It’s
not unusual for patients to seek less aggressive treatment options. This may
occur for a variety of reasons including misinformation, expense, fear of
surgery and co-existing medical problems to name a few. When
this situation arises a large variety of options exist for treating facial
aging. These include cheek implants, endoscopic mid face lifts, injectable
fillers, fat transfers, lasers and chemical peels.Without
pictures or a physical examination it’s virtually impossible to make a specific
recommendation regarding what options will benefit any particular patient.This decision will depend upon the patient’s
anatomic findings and aesthetic goals.Under
these circumstances consultation with a board certified plastic surgeon is
appropriate.This surgeon should be able
to perform an evaluation and formulate an appropriate treatment plan.