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What are alternative treatments to Botox and HIFU for saggy cheeks? (photo)

Aesthetic Medicine

I'm 36 and have fat saggy cheeks. I've done HIFU and jaw Botox before, however I am unsatisfied with the results as my cheeks still sag. What are other possible solutions?

DOCTOR’S ANSWER (4)

Hi Serene,

Other than HIFU cheeks and Botox of jaw muscle, non- or minimally-invasive treatments for sagging cheeks include:

1. Lifting with dermal fillers is commonly referred to as a liquid face-lift. Dermal fillers like Juvederm, Radiesse, and Restylane can be used to enhance chin sharpness, replace lost volume of the cheeks in order to smooth out the facial wrinkles and lift skin. Replacing lost facial volume from above, lifts the cheeks below, therefore reducing facial sagginess.

2. Ultherapy is a US-FDA approved lifting and tightening treatment using focused ultrasound. Ultherapy helps create a v-shaped face by tightening skin through stimulation of new collagen production in the deep supportive layers of the skin. Sagging skin along the jawline can be tightened and lifted, which in turn creates a v-shaped contoured face.

3. Thread lift treatments utilise threads which are inserted via a needle underneath the skin for lifting. The threads used now are generally either PDO threads or Silhouette Soft. These are dissolvable threads which improve the shape of the face by mechanically lifting the skin with cones or barbs called cogs. There is also delayed improvement through collagen stimulation.

I hope this helps!

Cheers, Dr Terence Tan

0 753 views 18 Oct 2018
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From the picture given, there is still some skin laxity seen.

Firstly, for the type of HIFU treatment that you did, what was the recommended number of sessions? This is because some HIFU treatments require more than 1 treatment e.g. monthly treatment x 3 sessions to see the full effect.

Secondly, how long ago was the HIFU done? This is because for HIFU treatments that only require 1 treatment session, it typically takes 3-6 months to see the full effects.

Thirdly, botox is not the right treatment for saggy cheeks if you're referring to botox of the masseters. In fact, that may worsen the jowling or saggy cheeks.

However, besides HIFU, other treatments that can be done for saggy cheeks include:

1. Dermalift

Thir procedure uses microdoses/diluted doses of botulinum toxin which are injected intradermally(not intra-muscularly) along the facial contours. This results in skin tightening and improvement of skin laxity along the facial contours.

2. Thread lift

This minimally-invasive treatment uses dissolvable threads which are inserted into the subcutaneous layer of the skin with anchoring, creating an instant lifting effect. It also stimulates collagen production which in the long run, is beneficial for skin lifting and rejuvenation.

0 956 views 5 Oct 2018
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Hi

Your cheeks aren’t actually fat or really that saggy. I think you may be confused!

If you mean that you had Botox for your masseters, that may actually contribute more to the saggy cheeks due to a sudden loss of bulk of your masseters without a corresponding lift of the cheek tissues, thus resulting in more sagginess. 

For your case, you would do well with a non-invasive threadlifting procedure that will lift the cheeks, nasolabial folds, and the jowls all at the same time. I personally prefer Silhouette Soft and Mint Lift for this purpose. These threadlifts can reposition the superficial fat compartments that had slid down due to aging . It will give you a lifted , refreshed look with the jowls and nasolabial folds reduced and the cheeks lifted. 

An alternative is Dysport injected intradermally at the hairline area , called the Dysport Dermalift  but that only lasts 4-6 months and the results are not as dramatic as the threadlift mentioned above. 

Hope that helps! 

0 973 views 4 Oct 2018
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Dear Serene,

From a limited lower face picture that you have provided, you would benefit from liquid facelift (fillers injected at a few precise anatomical locations to give you an instantaneous & lasting lift with no to low downtime).

For more lifting you may consider or combine with threadlift (options include PDO, PCL & PLLA). However, threadlift usually has a slightly longer downtime compared to liquid facelift.

Hope this helps!

Cheers,

Dr David Deng

0 907 views 6 Oct 2018
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