Sagging Cheeks – What’s the Most Cost-Effective Way to Rejuvenate Them?

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Before and After Deep Plane Facelift by Dr. Brian Machida

Sagging cheeks can make you look and feel old.   When inflation rises while economic growth slows, this can present a problem.  Years of research reveals that those who look young and attractive are more likely to get hired, get respect, get promoted and get raises.  Sadly, studies show that people who look old and tired are less likely to get paid well, and more likely to get laid off.  Sagging cheeks can play a big part in an older, tired look.  In a challenging economy, what’s the most cost-effective way to rejuvenate sagging cheeks?

First, it’s important to identify which areas of your cheeks contribute the most to an aging appearance.  Then it’s vital to learn which solution provides the greatest improvement.  Naturally, you’ll want the treatment that helps you look your best at a price you can afford.  We’ll provide some guidance here.

Revitalizing your upper cheeks

The upper area of your cheeks, known as the tear troughs, are the sections under your eyes, next to your nose, where tears naturally flow when your eyes water.  Aging in your tear troughs is common, but uncomfortably noticeable.  As we get older, natural fat deposits in the upper cheek and lower eyelid melt away.  At the same time, collagen and elastin levels that keep your skin firm decline every year.  Muscles start to sag.  This deepens your tear troughs.  Your lower eyelids can become puffy.  Bags appear under your eyes.

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Dark circles can start to appear in your 30s

Even worse, the uneven surface under your eyes can produce shadows.  These appear as dark circles.  Friends, or worse – your boss, start to ask if you’re having trouble sleeping.  You look tired.

After performing 6,000 facelifts in my career, you might think I’d recommend this procedure to solve these problems.  But a facelift is not the best solution for tear trough issues.  Lifting the tissues in your upper cheeks can make your tear troughs appear too flat.  When you were young, your healthy fat pads kept this area looking youthful and smooth.  Filling these areas can often correct the problems.

Fat transfer, if done correctly, can be the longest-lasting solution to aging upper cheeks.  It usually costs from $4,000 to $6,000.  If that solves the problem for many years, it’s a bargain.

Unfortunately, many patients don’t have enough viable unwanted fat to make fat transfer successful.  Those that do may need to lose weight for the sake of their health.  Losing weight will actually remove some of the fat we just transplanted in your tear trough.  And specialists with older fat transfer equipment often find that too many transplanted fat cells die once they’re in place.

Dermal filler injections are a more predictable treatment.  They cost less initially but will have to be renewed on schedule or that older, tired look will return.  As you can see in Nasolabial Folds – Facelift of Filler? Which Makes More Sense?” Bellafill is clearly the most economical filler option for your upper cheeks as well.  Bellafill can last 5 years.  At $1,200 per syringe (four syringes are often required), it’s not inexpensive.  But, with your investment lasting 5 years, it’s considerably less than hyaluronic acid fillers.  They need to be injected every year.

If you’re generally in-shape but have pockets of stubborn fat that you just can’t seem to lose, high-quality fat transfer like BeautiFill could be your best option to improve your tear troughs.  Otherwise, Bellafill seems to be a strong alternative.

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Before and After tear trough filler injections (stock photo)

Refreshing and lifting your mid-cheeks

A young face has fat pads between the underlying bones and skin.  These fat pads soften the face and provide a pleasing, rounded appearance to our cheeks.  As we age, gravity takes a toll on our facial muscles and fat pads, making them sag.  Hollows appear below our eyes.  Nasolabial folds emerge between the corners of our nose and mouth.  Further aging makes these deepen.  There are three ways to improve mid-cheeks:

Fat transfer or fillers:  If sagging is mild to moderate, dermal fillers or fat transfer can fill hollowed areas under the skin.  This can restore needed volume and lift your cheeks.  Fat transfer and filler injections, of course, have the limitations mentioned above:

  • Not enough viable fat that survives transplantation
  • Fillers must be replaced on schedule or sagging cheeks will return

A surgical procedure can provide a more reliable, longer lasting solution.

Cheek Implants:  If you’re young and have a naturally narrow or flat face, cheek implants can make a real difference.  The same is true if you sustained an injury to this area.  Some surgeons recommend cheek implants for sagging cheeks caused by aging.  If you’re considering cheek implants for facial aging, there are some things you should consider.

Cheek implants are symmetrical.  Cheeks are not.  To provide a natural look, your surgeon may need to shave down one of your implants.  But silicone doesn’t shave down smoothly.  It’s faceted, like a diamond.  A beautiful diamond requires a skilled diamond cutter.  In the same way, shaving down cheek implants is an art.  Not every plastic or facial plastic surgeon is good at it.  If you’re getting cheek implants, be sure to work with a board-certified specialist who can show you many good Before and After photos.

Facelift:  The most comprehensive answer to your sagging cheeks is the Deep Plane Facelift.  This facelift releases key ligaments deep under your face, permitting your surgeon to vertically lift your face further than the more common SMAS facelift can.  The deep plane procedure will lift sagging cheeks, dramatically soften nasolabial folds, eliminate marionette lines and facial wrinkles, and get rid of jowls.  It can also substantially smooth your aging neck.

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Before and one week After Deep Plane Facelift by Dr. Brian Machida, MD, FACS. Dramatic improvement, including in cheeks and nasolabial folds, is seen while patient is still healing.

A deep plane facelift can cost anywhere from $14,000 to $30,000 in the US, depending on who performs it and where you get it done.  “Surgeons to the stars” charge more for their name and reputation.  However, there are board-certified facial plastic and plastic surgeons located in places other than Beverly Hills and Manhattan who can charge significantly less for an excellent procedure.  As you’ll see in, “How to Make a $27,000 Beverly Hills-Quality Facelift Cost Much Less,” highly experienced facial plastic surgeons have methods for lowering your costs while delivering outstanding results.

Rejuvenating your lower cheeks

Sagging lower cheeks can result in a flabby, aging look.  The best way to rejuvenate your lower cheeks is a facelift.  A traditional SMAS facelift will accomplish this and eliminate jowls and marionette lines along with fine lines and wrinkles.  A deep plane facelift will do it better.  In a SMAS facelift your surgeon cuts or folds, then sutures, a quarter-inch horizontal strip of the SMAS membrane that lies above your main facial muscles.  The maximum lift they can achieve is about one-third of an inch.

The deep plane facelift can provide a much greater lift.  And while it’s lifting your mid and lower cheeks and everything else mentioned above, it’s also rejuvenating your aging neck.

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Before and After Deep Plane Facelift by Dr. Brian Machida

These days, SMAS facelift cost ranges from $10,000 to $16,500.  So, if your sagging cheeks and facial aging are too much for filler injections but not advanced, a SMAS facelift can save you money.  It often lasts about 10 years.  But if you need to rejuvenate your mid-cheeks, neck, or nasolabial folds, a deep plane facelift will give you much greater “bang for the buck,” especially if you work with the right surgeon.

Finding the right surgeon       CONTACT Dr. Machida Inland Empire, CA 

You can get outstanding results at an affordable price if you do your homework.  Look for a board-certified facial plastic surgeon or a plastic surgeon that specializes in the face and neck.  Find out how many procedures they’ve done.  There are highly experienced surgeons throughout the United States who do excellent work without charging “an arm and a leg.”  Many are in smaller cities, where office space is less expensive.  Some increase your safety and reduce costs by using local anesthesia plus oral sedation.

The right surgeon can tell you exactly what you’ll personally need to lift your sagging cheeks.  If you’re in Inland Empire, California, you can find me at STC Plastic Surgery in Ontario.

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About Dr. Brian Machida, MD, FACS

Dr. Brian K. Machida, MD, FACS is a double board certified facial plastic surgeon. He has an exceptional level of experience, having performed ( read more )

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