Volume Loss Or Volume Distribution Disorder In The Cheek?
25 March 2020 onur
It is necessary to distinguish between these two concepts.
If the problem is net volume loss, it is required to increase the volume in treatment. To do that, we can turn to adipose tissue transfer or filler applications.
If the problem is a volume distribution disorder rather than net volume loss, we need to take the volume from one place to another, that is, do surgical lifting (mostly midface lift).
The two procedures are often confused with each other.
First of all, it is useful to reconsider the term “net volume loss” as “net volume loss adjusted for age and body weight”.
In the aging process, the soft tissue mass of the cheek loses net volume. As long as the body weight of the person remains constant during the aging process, the cheek mass decreases over time.
Overweight patients are an exception to this rule. In overweight patients, the cheek mass may be larger compared to younger patients.
Similarly, in extremely thin patients, the cheek mass may be less bulky than the average of individuals of the same age and normal body weight.
In individuals with body weight at both ends, aesthetic interventions on the cheek mass do not yield good results, and long-term effects are unpredictable.
In a severely overweight individual, procedures such as facelift and midface lift often cannot sufficiently lift the heavy tissues. Even if surgery lifts the cheek mass sufficiently, it can make the face excessively round and wide. Even if overweight patients look very well after surgery, the soft tissue in the cheek will sag again as soon as the patient returns to normal weight in the future.
In a very thin individual, 3-4 sessions of adipose tissue transfer may be required to volumize the face. The cheek mass, which looks good at the end of these sessions when the patient weighs 45 kg, may appear too bulky for the patient’s face when the patient gets pregnant and weighs 70 kg.
In summary, if you are considering an aesthetic intervention for the cheek mass, you should know that your body weight should be in the ideal range and remain there during the postoperative period in order to achieve an ideal result.
After making sure that the body weight is in the normal range, the second thing we look at is whether the cheek volume of the person is in the normal range for their age. Plump cheeks can look beautiful in your twenties. In the forties, they look strange. Every age has its own beauty, and we want middle-aged beauties to have generally leaner, angled and expressive faces. Therefore, it is useful to reconsider our perception of beauty while augmenting the cheek volume between the ages of 30-50.
The majority of patients who complain about a lack of cheek volume also complain of sunken under-eye profiles, flattening of cheek contour, and piling up of cheek mass at mouth level. These complaints may be due to the cheek mass being located lower than it should be, rather than the net mass being insufficient.
When you draw a horizontal line starting from the nasal base, it is desirable that more than 60% of the cheek volume is above this line and less than 40% is below it. If most of the cheek mass is below this line, surgically lifting this mass will create a more effective result and a more natural appearance. Filling the relative space above this line in an individual who already has a low cheek mass results in an unsightly, chunky appearance.
If the tissue distribution is within the normal range, the patient’s body weight is within normal limits and the expected cheek volume is decreased according to the patient’s age, then it will be useful to augment the cheek volume with fillers or adipose tissue transfer.
Shall we lift the cheek?
Shall we fill the cheek?
Or shall we do nothing at all?
We can only answer these questions after physical examination and in line with the principles I mentioned above.
Therefore, we do not “work to order” to satisfy demands such as “I want a midface lift”, “I want fat injection”, “I want cheek fillers” or “I want a face lift”.
Please feel free to contact us for more detailed information on plastic procedures of the cheek.
Take good care…
… of yourself and your beauty.