“Saggy cheeks: how to remove the bruises on the face?”

“I am 40 years old. I look great (in any case, I often hear it from others), but at the same time I really don’t like bryl. What can be done and is it really possible to solve the problem of sagging cheeks without surgery?”

Ekaterina (40 years old)

The plastic surgeon’s response:

The formation of brylae occurs due to the fact that the mandibular fat pack moves downwards under the influence of gravity. This is the so-called “gravitational ptosis”, in which the ligaments inside the tissues and the ligamentous apparatus relax and the fat pack  it’s kind of slipping. Thus, the oval of the face visually changes, which really gives away the age. 

The first thing a doctor can offer after assessing the real state of affairs is ultrasound lifting on the Ulthera System device. This is a tissue tightening at a deep level, which has a prolonged effect. The procedure is usually performed once, after which, within three months, the contour of the face becomes more and more distinct. The maximum achieved result lasts one and a half to two years. Plasma therapy with hyaluronic acid is often prescribed together with Ulthera System to improve the quality of tissues. Another solution is contour plastic surgery (injection of fillers), which makes it possible to make up for the lack of tissue volume in certain areas and create symmetry.

The second way is thread lifting. Most often, threads with notches (fixing elements) are used to combat bryli.  The specialist takes a thread that has a fixing element, clings to the skin flap and moves it to the desired and aesthetically advantageous position, where it fixes. The effect lasts a year and a half. Even after the dissolution of the threads after 8-10 months, they leave behind a collagen framework that continues to perform a supporting function. Thread lifting is not a plastic surgery: there is no tissue detachment, so compared to plastic surgery, the result will not be as long. But thread lifting also has its advantages. First of all, it is non—traumatic and minimally invasive, and secondly, the price of the issue. And, of course, a short period of rehabilitation speaks in favor of threads: you can return to your usual life the next day or the day after the procedure. 

For those who want to restore a clear oval face for many years, it makes sense to think about plastic surgery. It’s not just the persistence of the effect, but also the fact that in some situations, only a surgical facelift of the lower third of the face can really help. By making an incision in front of the lobe, leaving and skirting the lobe from behind, the doctor gets the opportunity to grab a part of the muscle layer, lift it up, strengthen it in a new position and remove excess skin.  It should be remembered that in this case, the recovery period can take from two weeks to six months.

Plastic surgeon, chief physician of the clinic “Time of Beauty”.

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