Alexander Rivkin, MD
Expert Profile

User Photo For: AlexanderRivkinM.D.
Alexander Rivkin, MD
Plastic surgeon | Views: 243916

Friendname: AlexanderRivkinM.D.
Business Name: Westside Aesthetics
Website: www.westsideaesthetics.com
Location: 1033 Gayley Ave #104
los angeles, CA 90024
United States
Telephone: 310 443 5273
Languages Spoken: English

Post a reply Ask Alexander Rivkin a question Return to Alexander Rivkin's homepage

Ask An Expert > Alexander Rivkin Message Board > Mid-face lift or would another procedure be better?
User photo for: noreaster
Boston, MA
Mid-face lift or would another procedure be better?
I'm 35 years old and since I was young I've always had long/tear trough/cheek dents in my upper cheek area and lines that go from the corner of my mouth to the end of my chin/downturned mouth. When I was younger, it wasn't as pronounced, but now that I seem to be loosing facial volume over the last few years, I've started getting very pronounced undereye hollows as well as my cheeks are starting to hang/droop. Would I be a good candidate for fillers or would a midface lift and/or lower eye procedure be more beneficial for me?

Attached Media


Mid-face lift or would another procedure be better?

Plastic surgeon
los angeles, CA
United States
View My Professional Profile
Fillers  October 4, 2010 11:36 AM

I think that you would clearly benefit from fillers. You are too young for surgical procedures, in my opinion. Surgery is, like any other intervention, temporary. Results will last 10 years or so. However, each time you do surgery, there is some scarring that remains under the skin, making subsequent operations in the same area more complicated and risky. Surgery should be delayed as much as possible with fillers and toxins. Doing a lift at 35 signs you up to a lifetime of revision lifts and other procedures that become more and more risky and less and less successful as you age.
All you really need, from what I can tell by the picture, is filler (either Radiesse or a hyaluronic filler like Juvederm or Perlane, or a combination of both) to re-volumize that diagonal area across your cheek. You are correct to observe that it is the volume loss that makes you look older than necessary. Replacing that volume and refilling the cheeks lifts the focus of your face back up to your eyes - the most flattering focal point of anyone's face. Filling the cheeks also has the effect (partly real, but mostly an illusion of perception) of making the face look lifted.
It seems that you would also benefit from Juvederm filling of the tear troughs. This will eliminate the dark circles that you may be seeing under your eyes and make you look less tired. Its a quick procedure that has the added benefit of lasting 2 and sometimes even 3 years.
Needless to say, these filler procedures are somewhat tricky and should be done by an experienced, recommended professional.

  July 28, 2011 6:40 PM

you are very lucky, you have nice outside cheek bones and a high orbital rim to build from. get custom fitted and designed implants that fill out that void perfectly.

Plastic surgeon
Miami, FL
United States
View My Professional Profile
  July 29, 2011 5:56 AM

Thanks for the photo and question. I would try fillers or PRP fat grafts first before any surgery. Seek in person evaluations from boarded PSs in Boston.



Welcome to the Ask An Expert section of our website! Our network of board certified physicians can answer any questions that you may have regarding plastic surgery, skin care, dermatology and other conditions. Popular topics include tummy tuck, liposuction, rhinoplasty, acne scars, facelift, breast augmentation and more. This frequently asked questions section is opened to everyone and you need to set up an account with Makemeheal before you can ask your own question. This service is absolutely free and is available to those who are interested in learning more about a particular cosmetic procedure, treatment or product.

Before asking a question, we recommend you to browse through our existing collection of questions and answers to ensure that the question you want to ask have not already been answered by our highly experienced experts. This will help you save time and get an answer more quickly. When asking a new question, we recommend you to be very detailed so that our experts could formulate a more precise & professional answer.

Of course, this service is not a substitute for a doctor visit or a consultation with a plastic surgeon or cosmetic dermatologist. The answer you will find here only serve as initial directions of thoughts and not as specific instructions. You should remember that it is utterly important to consult a skilled specialist prior to scheduling any type of treatment in order to get acquainted with possible contraindications. Only a one-on-one meeting will enable your cosmetic surgeon to properly evaluate your condition, conduct examinations and explain their results.