Midface Lift or Mid Face Implant? (photos)

Thank you for the question and the photos. To figure out the best plan, an in-person examination is important. Generally speaking, facelifting is not the answer for a 31 year old patient. The issues you are seeing a most likely related to volume loss, perhaps with a little loss of elasticity as well. Facial implants or autologous fat transfer (fat grafting) would help with this. If you are having some laxity as well, non-surgical tightening can do great things for young patients. In my practice, we use two RF-based technologies (ThermiTight and Infini) to "shrinkwrap" the skin in younger patients. Best of luck moving forward!

Considering your age and the photos you posted I would not do neither a mid face lift or implants. You mention that you do not want fillers, but something more permanent. While we know that fillers are not long lasting, fat grafting certainly can be. In our practice we are shying away from cheek implants because the long lasting result from fat grafting is so good. You may want to reconsider fat injection.

The changes you are noting are part of the aging process that starts in the late teens and progresses in the twenties and thirties.  There is volume loss and volume redistribution that is very predictable.  This is why I designed a procedure called "Aesthetic Facial Balancing."  with AFB I restore youthful and natural appearing contours using the body's own fat or off the shelf hyaluronic acid filler products.  Precise and thoughtful volume replacement is what you need not a facelift.  I hope this helps!All the best,Rian A. Maercks M.D.

I am strongly recommending that you learn to embrace fillers.  They will cause much less harm than midface surgery or paranasal implants.  Your biggest risk is essentially prescribing yourself these surgeries due to a misconception of the perceived benefits of a permanent fix.  In my opinion, you will destroy your appearance if you go down this road.  The paranasal implant will distort the volume of the mid face at the base of the nose.  The complications from mid face surgery are so broad that I simply don't have space here to outline them.  Please understand that hyaluronic acid filler is now the state of the art for addressing precisely your issues.  Less is more.  The challenge is that these are fussy services but they do last for a year or more.  Finding the right injector in your community will be challenging.  I know because even though I am based in Beverly Hills, California, I see individuals who fly in for service from all over the country.  Fillers are reversible. While implants can be removed, the surgery used to place them causes irreversible changes to the face.  Similarly, the consequent of fat grafting are irreversible and cause unwanted scaring that will also harm you. Please be careful out there: Don't it always seem to go; That you don't know what you've got 'Till it's gone. Joni Mitchell

Hello and thank you for your question.  I do not recommend a midface lift for you.   Based on your
photograph, you are a great candidate for malar enhancement.  Malar implants can
be placed as a permanent way to gain volume in the cheek.  I always use
medpor implants with screw fixation.  Silicone malar implants tend to
have a high rate of malrotation over time.  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

jji008.   First off you don’t need any type of facelift.  Weight loss may have caused the changes you’re seeing your face. Fat grafting to your face is by far the best option for you because studies show that at least 50% of fat grafts to the face lasts permanently. While facial implants are an option, troubles arise if they become dislodged or are placed in the wrong position. Consult with a board-certified plastic surgeon to review your options. Best of luck.

In this case there is a decrease in volume around the cheeks and the chin. The best long term solution is not surgery as that would only tighten but not add volume. Since you do not want fillers, getting cheek implants and a chin implant is the best option.RegardsDr. Janjua

You do  not have significant signs of tissue relaxation which is not surprising given your age, and therefore a midface lift would not help significantly: there are no tissues to reposition.  A conservative small cheek implant can aesthetically be quite pleasing, and for a more subtle change, fat grafting can give a meaningful and relatively long lasting result.  An in person consultation would be necessary to more fully elucidate the options and expected outcomes.

The changes in the photos show a decrease in midfacial volume. Have you lost weight? At your age this significant weight loss can cause these changes. I think a midface lift would be a bit too aggressive. Lower malar implants are an option but again are a little aggressive. Considering your desire for someting which is either permanent or longer lasting, I wold recommend either fat grafting or Sculptra. Both are easy to do and very successful. Fat grafting is a little more of a "procedure" with a recovery. Sculptra is more of a gradual process but extremely easy without any real recovery. good luck.

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, the first surgical procedure I’d recommend is a mini lift, with or without a neck lift, depending on your needs. I hope this helps.