What can be done about weak mid-face? (Photo)

Question

Hello, I feel like my mid-face lacks definition, is it due to my jaw being too wide or is my skin already sagging at 25?

Semih Yildiz, MD, FEPOBRAS · Answer

In the photo, I do not see an obvious sign of significant skin sagging, especially at age 25. Mid-face definition is often more about cheekbone projection, facial fat distribution, jaw width, and lighting/angle than true laxity. A single photo cannot determine whether the jaw is “too wide,” but your concern may be related to the balance between the cheek area and lower face.

For a subtle improvement, the least invasive options are usually conservative cheek filler, careful lower-face contouring, or treatment of masseter muscle fullness with Botox if the jaw width is muscular. If the issue is skeletal jaw width or bite-related, that would require evaluation by a maxillofacial or orthognathic specialist rather than a facelift approach.

A facelift or midface lift is rarely the first choice at 25 unless there is a very specific anatomic problem. I would start with an in-person assessment by a facial plastic surgeon or plastic surgeon who can examine your cheek support, jaw anatomy, bite, and skin quality before recommending filler, neuromodulator, or any surgical plan.

Michael S. Kluska, DO · Answer

Atrophic, or under developed midface, is easily treatable, especially in a younger age with injectable fillers or fat grafting. It is my recommendation that you start this process now due to volume changes and as we get older your weak mid face will tend to be more apparent.

Donald Groves, MD · Answer

Hello and thank you for your question. When it comes to soft tissue enhancement, the main options I recommend are dermal fillers or fat grafting. 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. This differs from hyaluronic acid (HA) filler, the most common type of dermal filler, which typically degrades over about a 12 month period, meaning you need periodic re-injections to maintain the results..You would likely benefit from some filler or fat grafting to your cheeks to add some definition and refine your face shape, as you had mentioned. That said, it is difficult to provide any tentative recommendations, as there is only so much information to be gained from the one photo you have provided. I would recommend for you to come see me or another plastic surgeon for a formal consultation to thoroughly discuss your surgical goals, be formally examined, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) for your specific case. I hope this helps!
Best wishes, 
Dr. Donald Groves 
Plastic Surgeon

Arturo Valdez, MD · Answer

Thank you for your question. You're still young, and so, you are still producing collagen, and your collagen fibers are still strong, so you would be an ideal candidate for a non invasive esthetic procedure such as radio frequency. There are many variations of Radio Frequency, and this could stimulate the production of both collagen and elastin fibers and tighten the skin. This, combined with jawline liposuction or jawline liposculpture, could be your best option. Since we don't have a profile view of your face and neck, I can only guess that you have some fat deposits under your chin and along your jawline, and then a scar less necklift could be the best option.

Michael P. Morrissette, DDS, FACS · Answer

I would recommend that you begin with a temporary treatment like fillers to see if you like to the results. I think that you could benefit from anterior cheek projection. If you like the results with fillers, then a more permanent option would be cheek implants. They are placed on the bone and cannot be felt through the skin. Fillers likely need to be replaced once a year.

Zoran Potparic, MD · Answer

It does not appear that midface lift is necessery. It would be possible to achieve nice improvement with cheek , possibly chin augmentation. I would consider fillers first. Good luck.

Alan Gonzalez, MD, FACS · Answer

Hello @janerru, thank you for your question. A surgical procedure is a to invasive for your face.  It is very possible to improve the skin elasticity and define the edges of the face or mandibular line with a nonsurgical treatment like Ultherapy. This may be a non-surgical alternative. It is important to consult one or several board certified plastic surgeon for more information and recommendations. Best wishes! Alan Gonzalez MD FACS. American Society of Plastic Surgery Member (ASPS),   International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP).

Jeffrey H. Spiegel, MD · Answer

Essentially, we need more photo views to know, but, it may be that you simply need more structure.  Anterior (submalar) cheek implants or a filler there, and a chin implant (or a chin filler) could very likely provide more attractive definition.  Both are easy office procedures.

Jacob Tower, MD · Answer

Hi, hope you are well. One of the most important aspects of midface aesthetics is your cheek projection and width. Everything is relative. It would be most helpful to analyze your proportions with a complete A-P view and profile view. This allows to see how the chin, angles of the jaw, and cheek bones contribute to your facial structure and whether any augmentation/reduction makes sense. Skin elasticity is generally a low concern at age 25.
Best,Dr. Tower

Connie Hiers, MD, FACS · Answer

You are neither weak or sagging. However, you could get some improvement with noninvasive micro-needling with radiofrequency like Secret to help improve your overall skin tone and tightening.

What can be done about weak mid-face? (Photo)

Answers (11)

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