Thank you for your question. You describe that one cheek is droopier than the other, and when you do a mirror lift, you find the cheek is more symmetric with the other. You’re asking what procedure would best help you. In the absence of a photo, I can conjecture your current state of facial aging based on your description. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years, and solutions for facial aging and asymmetry are what we do every day in our practice. From your description, if both cheeks aren’t significantly drooping, and your perception is one cheek is drooping a bit more than the other, it’s reasonable to conclude in terms of facial aging, you are dealing more with the volume and anatomic change rather than sagging. Facial aging is both volume loss from most significantly from bone, then muscle, fat, and soft tissue, which is underappreciated; as well as sagging. Although there may be some degree of sagging. When we look at a patient, we look at what is contributing to their main area of concern. Understanding you’re looking to create symmetry with the other side, and when you do a little lift you are able to improve that symmetry, my thinking is you’re probably dealing with a subtle but definitive asymmetry in the relative projection of the cheekbones. This is anatomic and normal, which pretty much applies to everyone, but you’re also dealing with the difference in volume. When you do that vertical lifting, you’re actually shifting the volume upward. When it comes to volume loss, we live in a very fortunate time. We have a technique we use in our practice called structural volumizing. Structural volumizing entails the placement of a long lasting hyaluronic acid filler such as Juvederm Ultra Plus or Juvederm Voluma, which by their chemical design, is designed for lasting longer at about in the 1-2 year range. In structural volumizing, we’re placing this material at the bone level to address the most important aspect of facial aging which is bone loss. When it’s placed at this level, the appearance gives the face more structure, hence the name. I think it’s very important to differentiate this technique from the typical approach to cheek enhancement, which is to place filler just under the skin to try to re-inflate some of the deflated skin. Rather, by placing this material at the bone level, the skin does re-inflate, but at the same time it looks more angular, more youthful. There’s something called the golden ratio which is a very important aspect to beauty in faces and in nature all around us. When you create volume at the right place on a structural level, you restore this golden ratio. It’s a very nice and elegant enhancement that looks very natural. I think when you entertain the idea of possibly lifting, a procedure such as a mid facelift may have some value. However, in my experience and perception of mid face lifting, or any type of procedure trying to shift volume from the lower part to the upper part of the face, very often it falls short in true volume correction. By throwing off these natural proportions, it makes someone look plastic. That’s the look where you know somebody had something done, but they don’t quite know exactly what, and assume it’s some type of face lifting procedure. With structural volumizing, we’re restoring a lot of the volume rather than trying to lift and displace the existing volume to a place where it might have an unfortunate downside and won’t be as effective. Structural volumizing in the mid face will probably be worth pursuing. Again, without a photo or a physical exam, I’m trying to use the basic limits of the description to give you a suggestion as to what I would do for patients like yourself who come to our practice. I hope that was helpful, I wish you the best of luck and thank you for your question.