Cheek Sagging after Cheek Bone Reduction Surgery

Q: Dr. Eppley, I am from China an am 23 years old. Please read my story and give me advice.

One year ago I went to Korea for V-line surgery and the cheek bone reduction surgery because Korea is very famous for Asian small face surgery. My face before was very not symmetric and very ugly and not like a girl !! I have put old photo of my face in the email. If you see photos, you can see that my cheekbone was very very big. My old face – one cheekbone very bigger than the other cheekbone and more meat on the face if you look at the photo carefully.

My Korea doctor used very popular technique called 3D rotation malar reduction. This technique uses L cut in front of cheek bone and cut the back in the hair. Then push the bone in and fix with the use of titanium plates and screws. I do not know how many mm of bone were taken out. 

My face after surgery got very smaller and I was very happy. The result very dramatic and my face very likeable. But one year after surgery, I have a big problem.If you look at after photos in the email, the meat of my face drooping. There is too much meat on the face and it makes my face look old, chubby, nasal labia lines! I was very angry!! Doctor said 3D rotation malar reduction have little chance of cheek drooping because of plate fixation and bone rotation and because I am young.

I flied back to Korea this month and he say thread lifting is good solution. I was very angry again because thread lifting is not permanent fix and only last very short time. I can’t pay for thread lift over and over until I die. Korean doctor then refused to fix my drooping face, and now I do not know what should I do.

My big problem is the extra meat on the nose making nasal labia lines. What is your advice on how to fix? I try skin tight laser but no effects… What can I do to fix?…

Should I do face liposuction to get rid of the extra meat or redo surgery? Can I do cheek lift to move cheek meat up high when I am still young? Is it possible?

I want to hear your reply soon, thank you.

A: What you have experienced after such cheek bone reduction surgery is not rare and is what can happen when there is loss of bone support. The overlying soft tissues may or may not contract down completely in a 3D fashion. Such effect can take up to a year after surgery to see whether it fully does or not.

The cheek sagging to which you refer/have is not an easy problem to fix. Nothing non-surgical, like lasers or any other device is going to work. Liposuction will largely be ineffective and threadlifts have a temporary effect at best.

Some form of a cheeklift is needed or resuspension of the tissues. An intraoral approach is one option with Endotine fixation. Other superior options are through the lower eyelid or temporal scalp incisions to do the lift. My personal preference is for a cranial suspension technique which pulls the cheeks vertically upward, which is the best direction for resuspension as that is how they have fallen.

Dr. Barry Eppley

Indianapolis, Indiana