Can A Cheek Lift Fix My Sagging Face After Cheek Bone Reduction?

Q: Dr. Eppley, I wanted to restore my cheekbones and the saggy soft tissue with an endoscopic midface lift after cheekbone reduction. I found a very good maxillofacial surgeon and a plastic surgeon who worked together to bring my zygomatic bone to the old anatomic position and lifted the sagging soft tissue. That surgery was exactly six weeks ago. I know that swelling from jaw surgeries are extreme and lasts a long time but I am very afraid because I still can’t see the Ogee curve and high cheekbones that I had before the zygoma reduction. There is an improvement but not so much. I don’t know if it is because of the swelling that are all around my mouth, nasolabial folds and upper lip or if he didn’t lift enough or what could be the reason for that? I know I have to wait six months until one year to see the result but what can I do if my surgeon didn’t lift enough. ( I trust him but I know that my case was difficult because of the cheekbone restoration at the same time) Is it possible to lift the fat pad again after one or two years or is it too difficult? Otherwise I don’t know what to do, it still look  a little bit saggy (maybe because of swelling)

A: With the scarred tissue from these two surgeries (cheek bone reduction and cheek bone elevation and fixation), it is highly unlikely you will get significant improvement with any type of attempts at midface or cheek lift. The tissues are both scarred and atrophic and their elevation will be both difficult and limited. While you need to let the swelling subside so you can judge the final result, I doubt it will be much different than before surgery. (remember the result is going to look worse as all swelling subsides.

Any effort at cheek sagging improvement in the future can only use the approach of adding volume to lift the sagging tissues…but that is exactly what you were looking to avoid from the beginning. (too much cheek fullness) I am afraid you have reached the point where the cheek result you have is as good as it is going to get unless you are willing to acccept other trade-offs.

Dr. Barry Eppley

Indianapolis, Indiana