The middle third of the face is the lower eyelids and cheeks, and they can be a particular problem in people who have lost weight, when they develop a gaunt appearance. Loss of facial fat is a natural part of ageing as well, so if you decide you go on a health kick in your middle years, often your face won’t thank you for it!
Just like the upper eyelids we spoke about previously; the lower eyelid has fat compartments which bulge forward as tissues weaken over time. A lower eyelid reduction or blepharoplasty is designed to reduce the fat bags and also to remove some of the loose skin that inevitably forms with time. In addition, there is often a groove that appears between the eyelid and cheek, known as the tear trough, and micro fat transfer can be of great help in diminishing its appearance. This surgery requires a general anaesthetic and is performed as a day case procedure, resulting in bruising and swelling for 2-4 weeks depending on each individual.
The “face” to me is a triangle of tissue that runs from the lower eyelid, down the groove between the nose, cheek and lip and the side of the face. When is looses volume, the crease between the nose and the cheek (called the naso-labial fold) becomes more pronounce, the cheekbones look hollow and often a small jowl appears in the jaw line. Whilst is might look like the face has sagged, often is has simply deflated, and replacing fat with a transfer procedure will improve the face greatly. If things have genuinely sagged in addition to losing volume a “face lift” procedure (of which there are many, many types), is required to improve things.
As with all surgical procedures, outcomes are very variable, and once person’s idea of an improvement might seem no different to the next. Part of a consultation process is trying to describe the changes that you are expecting and to get your surgeon to appreciate your vision. It isn’t surprising that sometimes the two things don’t agree. Probably what is more surprising is that usually they do!
Tomorrow we will talk about the lower face or neck, which is the second most common area that people want to have improved over time.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.