Temporal Cheeklift for Management of Cheekbone Reduction Soft Tissue Sag
Q: Dr. Eppley, I am six months post-op cheekbone reduction surgery. I am happy with the results from the bony perspective as my face has been effectively narrowed, but there were some trade offs. I have some slight sagging of the midface which is evident in the form of hollower eyes and deeper nasolabial grooves.
I’m 24 years old and I’m booked for a cheek lift procedure in ten days. It is an understatement to say that I am absolutely terrified about the uncertainty of the operation and its outcomes.
My surgeon will be taking two 2-3 cm incisions in the temple, and reusing my oral incisions from the zygoma reduction. He will lift my cheeks off the bone and suture them to the temporal muscle.
However, I haven’t read a lot of good things about this procedure. Most people seem to have complaints about looking too pulled up or cat-like or too full in the cheeks after the operation. I asked my surgeon not to make the eyelid incision as I am still young and of Asian-descent.
My sagging was only slight and I would hope that I just get a slight lift of the cheek tissues. I am deathly afraid of looking too full or too pulled or my cheeks changing their shape dramatically.
From your experience of midface lifting in young individuals after cheekbone osteotomies, what kind of results can I expect? I just want a conservative redraping of the tissues slightly higher but it’s just so hard to communicate to my surgeon what “conservative” means.
I’ve read about an 18 year old removing implants and getting the same type of midface lift to correct sagging, and she mentioned it warped the shape of her cheeks. Please provide any insight you have about my situation.
A: The fundamental problem with a temporal cheeklift is that the vector is oblique while the direction of the cheek sagging has occurred in a vertical direction. Thus a swept back look is possible based on the direction of the pull. To make a vertically directed cheek lift a cranial suspension technique is needed. This is similar to the temporal cheeklift but the incisional access and the suture placement is directly upward in the scalp.
Dr. Barry Eppley