Thank you for your question.
You submitted a question without a photo but you describe in your question that one cheek
is droopier than the other and that when you do a mirror lift, you find that the cheek
is more symmetric with the other.
So you’re asking about a procedure that would best help you.
Well, in the absence of a photo, I think that I can at least conjecture as to what your
current state of facial aging probably reflects based on that description.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years and solutions for
facial aging and asymmetry is pretty much what we do every day in our practice.
So in the description of your question, I think that we can conclude that if both cheeks
aren’t significantly drooping but your perception that one cheek is drooping a little bit more
than the other, I think it’s reasonable to conclude that in terms of facial aging,
you are dealing more with the volume and anatomic change than you are dealing with sagging.
Now although there may be some degree of sagging, but just to understand that facial aging is
both volume loss, bone muscle, fat and soft tissue, significantly on bone which is underappreciated
or as well as sagging.
So when we look at a patient, we look at what is contributing to what is their main area
of concern.
So with the understanding that you’re looking to create symmetry with the other side and
that when you do a little bit of a lift, you are able to improve that symmetry, my thinking
is that what you’re dealing with is probably a subtle but definitive asymmetry in the relative
projection of the cheekbones which is anatomic and normal and it pretty much applies to everyone.
But you’re also dealing with the difference in volume.
And so, when you do that vertical lifting, you’re actually shifting the volume upward.
Well, when it comes to volume loss, I think that we live in a very fortunate time.
We have a technique that we use in our practice called structural volumizing.
And what structural volumizing entails is the placement of a long lasting filler such
as a hyaluronic acid from the Juvederm Ultra Plus or Juvederm Voluma categories, which
by their chemical design, is designed for lasting longer.
And when I say longer, I’m talking about in the 1-2 year range.
When we do structural volumizing, we’re placing this material at the bone level.
So it’s really addressing the most important aspect of facial aging which is bone loss.
And when it’s placed at this level, the appearance actually gives the face more structure,
hence the name.
I think that it’s very important to differentiate this technique from what is the typical approach
to cheek enhancement which is to place the filler just under the skin to try to essentially
re-inflate some of the deflated skin.
But rather, by placing this material at the bone level, the skin does re-inflate but at
the same time, it looks more angular.
It looks more youthful.
There’s something called the golden ratio which is a very important aspect to beauty
in faces and in nature all around us.
And when you create volume at the right place, in a structural level, you restore this golden
ratio.
It’s a very nice and elegant enhancement that looks very natural.
I think that when you entertain the idea of possibly lifting, yes, a procedure such as
mid facelift may have some value but I would say, in my experience and my perception of
mid face lifting or any type of procedure that tries to shift volume from the lower
part to the upper part of the face, very often it falls short in the true volume correction.
And by throwing off these natural proportions, it actually makes someone effectively look
plastic.
And that’s that look where you know that somebody had something done but they don’t
quite know exactly what.
You assume that it’s some type of face lifting procedure.
So with structural volumizing, we’re actually restoring a lot of the volume rather than
trying to lift and displace the existing volume to a place where it might contribute but with
the unfortunate downside, I think that it’s not going to be as effective.
So structural volumizing in the mid face I think will probably be worth pursuing in terms
of your knowledge and appreciation.
Again, without a photo or a physical exam, I’m trying to use the basic limits of the
descriptions to give you a suggestion as to what I would do for patients like yourself
who come to our practice.
So I hope that was helpful, I wish you the best of luck and thank you for your question.