Cheeklift after Cheekbone Reduction

Q: Dr. Eppley, I am quite stuck and I hope you could provide some surgeon’s insight on my situation. After my cheekbone reduction, I noticed slightly deeper tear troughs lines and minor deepening of the nasolabial sulcus. The sagging was minor, but of course I was hoping for none. I’ve been consulting for cheek resuspension surgery. 

Every surgeon I’ve been to, I’ve explained my surgical history thoroughly as well as my surgical goals – which in my opinion are very reasonable. I know the hollower eyes most likely won’t be helped without an eyelid incision, which is something I am not ready for. I’ve accepted it and it doesn’t bother me too much. 

What does bother me is the nasolabial grooves and cheek puffiness towards the front of my face. I think a temporal and intraoral incision cheeklift procedure would help me solve this aesthetic issue. When I push the front of my cheeks outwards towards where the temporal incision would be, I like what I see.

However, the few surgeons I’ve visited have made me start to lose hope. Even with the surgically induced drooping, they state I am too young for a cheeklift and should stick to fillers. I really don’t want to keep going back to the office every 6 months or so until I age enough to actually get my desired surgery done. Financially and time-wise, it would be hard on me to keep getting fillers, year after year after year, as I am only in my 20s. Even if the resuspension surgery would cause major swelling, I would rather just deal with the whole ordeal once and then move on with my life. 

Is age really the only reason why I am being rejected for cheek resuspension surgery, do you think, or is there something more to it? Is there such a big risk for looking unnatural or ‘wind-swept’ if I were to pursue correcting minor sagging of the cheeks after cheekbone reduction. 

I’m really at a loss. I don’t think the end result that I want is unrealistic and since the sagging was instigated surgically, I don’t see why resuspending tissues that dropped would be ‘too much for my age.’ 

I really can’t understand if it’s me or if it’s the surgeons I’m consulting with.

A: While pushing up the cheek tissues towards the temporal region creates the desired effect, it is surgically not that predictable or simple. Lifting of any facial tissues is based on the concept that the tissues are loose and minimally elastic, as in older patients due to aging. In younger tissues they do not move the same way or stay as well even when repositioned. So to a large degree your young age is the reason surgeons are not very enthusiastic about doing any cheek lift on you. It is not a question of whether your goals are unrealistic it is really whether they are possible or worthy of the effort.

Of course there is one way to answer that question..have the cheeklift procedure done as it will either be successful or it won’t. But then you will know for sure. 

Dr. Barry Eppley

Indianapolis, Indiana