Cheeks

Cheeks

 

Prèface Cosmetic prides itself in rejuvenation of this part of the face.

 

As mentioned in other areas of the website, Dr Hollenbach has had extensive expertise in surgery techniques around the eyelids, however the cheek area is of equal importance to many people and Dr Hollenbach has had experience in rejuvenating this part of the face, using different techniques over the years.

 

As we age, our cheeks tend to droop. This is called mid-face ptosis or cheek ptosis and is an inevitable consequence of ageing. The ‘high cheekbone’ is always aesthetically valued. However, even those of us blessed with ‘high cheekbones’ may find that with age they are not as prominent as they once were.

How does cheek contouring and lifting work?

Dr Hollenbach offers a number of techniques in trying to restore the normal cheek contour. Surgical techniques include mid-face lifting which can be divided into lifting straight up or what is called a vertical vector or elevating ‘up and out’ which is often called a superolateral vector, this is where the cheeks are lifted out towards the temple area rather than straight up.

 

Depending on your facial configuration, generally it is one technique or the other that will be more aesthetically pleasing. Both techniques use Endotine anchors, which are placed beneath the muscles of the cheek and then sutured in place. Just as Endotine anchors are used in brow lifts and absorbed, these anchors too are absorbed over a period of time. The cheeks continue to be elevated over this period and beyond as there is collagen deposition and scarring in the deeper tissues, keeping the cheeks in the desired position.

What are cheek implants?

Whilst Dr Hollenbach has performed cheek implants in the past, these are not his preferred option as he feels that a more natural cheek appearance can be achieved using mid-face lifting. Cheek implants often produce an overdone appearance, or even worse, can migrate with time and look completely unnatural.

Adjunctive procedures for cheek lifting.

Mid-face or cheek lifting can be combined with lipofilling, using fat from the abdomen, which is described in great detail on our lipofilling page on this website. Lipofilling can be performed as an independent procedure as well but is best performed in conjunction with a mid-face lift.

Are there less invasive options?

For those who would like a less invasive procedure, threadlifting is a good technique in the cheeks, using a combination of both anchoring and free-floating Aptos PCL threads. This is a very good technique in younger patients, however it often does not have great longevity in older patients.

 

For these older patients cross-linking thread techniques are combined with lipofilling and other treatments, where a foundation of collagen is encouraged in the cheek area to form a collagen platform. In time, usually 6-12 months, this area can be lifted as a unit using more traditional threadlifting techniques. This then becomes a two-stage procedure.

Our philosophy regarding other techniques.

Unfortunately in the cosmetic world dermal filling has become the mainstay treatment in the cheek area. Dr Hollenbach strongly discourages this as there are many side effects associated with dermal filling, as well as the appearance of being overdone which is all too familiar to us now.

 

Artificial dermal fillers tend to migrate over time and even though they are marketed as short acting, there is evidence in MRI scanning that they can persist in the injected areas for many years. It is for this reason Dr Hollenbach stopped doing this procedure some years ago and encourages the use of a more organic and natural ways to treat this area such as using lipofilling techniques.

 

There is no one treatment that is best for everybody in this area. Dr Hollenbach will be happy to discuss which treatment might be best for you and will indicate which option he feels is best for your particular circumstance, understanding your aesthetic desires.

To find out more about cheek lifts click here

Willem Dafoe and his iconic marionette lines

Marionette lines

 

A mainstay of dermal filler cosmetic treatment has been the injection of dermal fillers into this part of the face or even using anti-wrinkle injections.

 

The true cause of marionette lines however is due to Cheek Ptosis and one only has to manually push up the cheeks to see what happens to this marionette lines. Generally, they magically disappear with elevation.

 

In other words, mid-face lifting, cheek lifting, thread cheek lifting, or lipofilling the cheek will generally improve marionette lines.

 

It has been a long time since Dr Hollenbach has sought to improve the appearance of these lines by doing anything to the lines themselves. Co2 laser over the entire face will also soften these lines, however, if not performed with some sort of mid face or cheek procedure, the results are disappointing.

Discover whether cheek lifts are right for you.