Q: Dr. Eppley, awhile ago you helped answer my questions about cheek lifts, as I was getting one to correct sagging from malar implant removal. Well, I had the cheek lift, and while it made some major improvements, I still have some sagging.
Now I probably should just accept the remaining sagging at this point, but since I had NO sagging on my face while the implants were in, I am of course beginning to wonder if I should have just kept them or should replace them or get some sort of filler to fill out the loose skin at some point.
My reason for removing the cheek implants was that unfortunately I felt they were not proportionate and looked a bit obvious - but in retrospect I wish I had just waited for more swelling to subside and embraced the new look rather than removing them and making myself look older.
The issue remaining seems to be mostly skin (with a tiny bit of tissue). The pocket of looser skin is still in the shape of a malar implant.
Is it possible that replacing the malar implants in the future would help fill out this looser skin - or after all of these surgeries should I just give up on having tight mid face skin again? You can be honest, I know it’s a lot
Would replacing the malar implants after placement, removal, and a lift just be too much scar tissue and way too complicated? How long should I wait before making this decision?
I regret removing the implants, as they made me look much younger and I had no idea I’d have sagging if I removed them.
I just keep wondering if re-inserting the malar implants would lift that tiny bit of excess skin that is looser since removing them. Perhaps filler might do the trick too?
Also, I forgot to mention that if you do think reinserting the malar implants would lift the skin a bit how long would I need to wait after the cheek lift. I was told that the sutures dissolve in 6 months. Would it be safe for the implants to be in there theoretically even if the sutures had not dissolved?
Any other suggestions about how to lift that sagging mid face skin are greatly appreciated, or if you think i should throw in the towel and quit and just accept the sagging skin now as it’s just too much surgery and scarring that’s understandable as well.
A: I think given your past history of cheek implants in and then out, any further efforts at cheek lifting should be done by either injectable fillers or fat injections.They both will provide more upper cheek fullness and will do some cheek lifting. Ultimately cheek implants could be redone now that you know their benefits. But you need to wait a full year after the cheek lift before replacing them with fillers or fat if they turn out to be inadequate.
Dr. Barry Eppley