Do I need a facelift? How can I fix these strange ripples on the mid cheek? (Photo)

Based on your photos, I do not think that surgery is going to give you the best results. It's worth exploring procedures such as Silhouette Instalift, PDO threads, and fillers to help treat the folds/ripples that you are seeing when you smile. Sometimes a combination of these will give the best improvement. Treatment for pores can involve using medical grade skin care, radio frequency devices, and laser resurfacing. 

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another.  See the below link on some suggestions on finding the most qualified Plastic Surgeon for you.  Always insist on a board certified plastic surgeon.

Thank you for your question and picture.  A facelift targets the lower part of the face, so sharpens the jawline by removing the jowls. This is its main purpose, so a facelift wouldn't get rid of the nasolabial folds or ripples.  Unfortunately, even young children with no skin laxity can get line when they smile.  You could use fillers or resurfacing techniques to soften.  All The Best 

Simply put, nobody "needs" a facelift.  However, the limited photo presented suggests that a facelift would not be something I would suggest as a remedy for facial aging at this time.  There are a myriad of minimally invasive options available that could be addressed in a consultation with a Facial Plastic Surgeon

With limited evaluation from the photo provided, your skin texture is very nice and significant laxity is not apparent.  Weight loss can result in some slack but at your age, it usually tightens fairly well unless the weight loss is extreme.  Some options to help firm the skin include hydration from good skin care, chemical peels, micro- needling, and CO2 laser and others. If the lines themselves are the only concern, there are some newer HA fillers that are more flexible to soften lines in that region while retaining natural expression. Based on the pictures and history, I would not consider a facelift. Hope this helps. 
Dr. Fink

Hello,Thanks for your question. Congratulations on the weight loss. What you are seeing is de-volumization of the skin with loss of subcutaneous fat. The best way to manage this is to add a little volume back under those wrinkles and resurface the skin. This will also help the appearance of the pores. Adding volume could be in the form of microfat injections or filler injections. Depending on your needs and tolerance for risk, resurfacing could include the following: microdermabrasion, chemical peels, microneedling with PRP or chemical peels, RF microneedling, RF skin tightening, or fractional laser resurfacing. I would recommend that you consult with a facial cosmetic surgery specialist for the optimum outcomes. I would not recommend a facelift just yet because you are so young and you still have excellent collagen and elasticity. A little medical skin care will be necessary after your procedures to maintain the look long-term.Good luck,Dr. Shah

Hello Musique,Let me start by saying you have a beautiful smile!But with weight fluctuations, you can expect to see changes in the soft tissue of the face.  Only in cases of extreme weight loss would a person your age require a face- and/or neck-lift, so I would urge you not to seek surgery just yet.That being said, there are a variety of less-invasive treatments that can help decrease the appearance of the 'ripples' you mentioned, as well as improve the skin texture and tone.  These range from filling techniques (such as injectable hyaluronic acid fillers or fat transfer) to resurfacing techniques (with micro needling/PRP or fractional CO2 laser) to tightening (radio frequency technologies).I suggest you go for an in-person evaluation with a trusted facial plastic surgeon to see what your options are and go from there.Best wishes,Dr. Jay

Thank you for the question and your photos. It seems a bit early for a facelift. However, particularly after weight loss, some patients will have extra skin in the cheeks. This can give an appearance of sagging or wrinkling. To combat this, judicious use of fillers or fat may help by adding some volume back to the area. In addition, there are a variety of non-surgical tightening treatments available now. I prefer InfiniRF and ThermiTight in my practice. Best of luck moving forward!

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Based on
your photographs and age, you do not need a facelift..  Fillers may beneficial for you.   This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

You do not yet have enough sagging to justify a facelift. Concentrate on preventing sun damage by protecting your skin with sunscreen, hats and clothing. Have your dermatologist recommend a medical-grade skin care regimen with retinol and hyaluronic acid. Get regular chemical peels. If you do start to see some jowling, a mini lift, with or without a neck lift would give improvement. I hope this helps.