Improving Sagging Cheeks with a “Vertical Lift”! Understanding the Role of the Under-Hamra Technique in Mid-Facial Lift. A Renowned Plastic Surgeon Explains.
2025.3.11
Sagging, shadowed dark circles, and drooping cheeks due to aging greatly influence the overall appearance of the face.
Especially, the hollows and sagging around the eyes, as well as the disrupted jawline, can give the impression of being "tired" or "aged." By combining the under-Hamra technique and vertical lift, you can achieve a more natural and youthful result.
In this article, we will explain the characteristics of each procedure and the benefits of combining them in detail.
First, we will introduce the case of Dr. Nagura, a famous liposuction doctor.
CASE 01
In their 20s

【Case explanation]】The face line was sluggish due to buccal fat. By removing fat, my skin becomes less sagging and has a beautiful contour no matter which direction it wraps around.
CASE 02
In their 30s

【Case explanation】 People whose lower cheekbones appear sunken. By injecting the harvested fat into the cheeks, a beautiful contour with no dents was created. The fat under my chin has also been reduced.
CASE 03
In their 40s

【Case explanation】 People who have fat on the side of their mouth that makes their outline look square. By removing fat from the sides of the mouth, the contours have changed to a feminine one. Also, by removing the fat under the chin, the face line from an angle became more beautiful.
CASE 04
In their 50s

【Case description】 A patient had fat in his cheeks and under his chin, making his face look round. By taking the appropriate amount of fat, you can maintain a rounded shape while creating a clean contour.
CASE 05
In their 60s

【Case explanation】 When you look at it from the front, it doesn't look like there's a lot of fat, but when you look at it from an angle, you can see that there is fat. The sagging area under the chin due to age has been transformed into a more youthful face by removing fat and lifting it with a thread lift.
Why is Dr. Nagura chosen by many patients both domestically and internationally?
REASON 01
01.Dr. Nagura's dedicated state-of-the-art operating room.

REASON 02
02.Over 10 lectures at domestic and international conferences. A leading cosmetic surgeon representing Japan.

REASON 03
03.He has been the number one in the country for 7 consecutive years in the number of liposuction procedures performed on the face.

- Thread Lift: No. 1 in the country for 6 consecutive years (2019–2024)
- Buccal Fat Removal: No. 1 in the country for 7 consecutive years (2018–2024)
- Jawline Fat Removal: No. 1 in the country for 3 consecutive years (2022–2024)
- Malar Fat Removal: No. 1 in the country for 3 consecutive years (2022–2024)
- Liposuction (Including Body): No. 1 in the country for 4 consecutive years (2021–2024)
With an overwhelming number of cases supporting it, his exceptional technical skill and knowledge create natural beauty.
REASON 04
04.Named the 'Best Aesthetic Surgeon in Japan' for two consecutive years.

REASON 05
05.The only fat removal and rejuvenation expert doctor at SBC.

REASON 06
06.15 years of experience in cosmetic surgery.

REASON 07
07.Presentation on Revision Surgery at Academic Conference

REASON 08
08.He has performed numerous complex and revision surgeries.

REASON 09
09.Performed many surgeries as a cosmetic surgeon

REASON 10
10.Performed surgery on my own mother.

With this mindset, I decided to carry out the procedure to fulfill my mother's desire to "look younger." Instead of making drastic changes, my goal was to help her look naturally 15 years younger.
REASON 11
11.Aesthetic Surgery Instructor

REASON 12
12.He has performed surgeries on numerous celebrities.

REASON 13
13.There are over 200 staff members and doctors waiting for surgery.

REASON 14
14.I handle a wide range of patients, from men to individuals in their 20s to 70s.

REASON 15
15.Appeared on television as a skilled surgeon.

REASON 16
16.Two-time champion of the "Plastic Surgery Cinderella" contest.

REASON 17
17.Developer of Liposuction Injections and Suction Lift.

REASON 18
18.Trust from patients.

REASON 19
19.Trust from staff and family

REASON 20
20.Dr. Nagura is capable of performing surgeries for the eyes, nose, facial contours, and nasolabial folds.

REASON 21
21.Board-certified plastic surgeon and certified regenerative medicine specialist.

REASON 22
22.Awarded the Best Clinic Award.

1. What is a Vertical Lift?
POINT 01
A vertical lifting technique that brings out youthful vitality.

While a typical facelift lifts the skin horizontally (laterally), the vertical lift stands out for lifting the skin "vertically (upward)."
【Main Features of Vertical Lift】
・Restores cheek fat to the appropriate position, giving a fuller, more youthful appearance.
・Improves sagging around the mouth and reduces the appearance of nasolabial folds and marionette lines.
・The upward lifting direction prevents unnatural tension, resulting in a natural finish.
While a vertical lift can be effective on its own, it is especially recommended to combine it with the Transconjunctival Orbital Fat Repositioning technique if you are concerned about dark circles or hollows under the eyes.
2. What is the Transconjunctival Orbital Fat Repositioning Technique?
POINT 01
A revolutionary treatment that naturally improves dark circles and sagging under the eyes.

Traditional fat removal procedures only removed fat, often resulting in hollows after surgery. The under-Hamra technique, on the other hand, redistributes the fat, achieving a natural result.
【Main Features of Transconjunctival Orbital Fat Repositioning】
・Evenly redistributes the fat under the eyes to improve dark circles and hollows.
・No incisions are made, leaving no visible scars.
・Prevents hollows and helps maintain youthful eyes for a long time.
3. The Basic Concept of Lift Treatments
POINT 01
Addressing the root cause of sagging to achieve a natural result.c
【Basic Principles of Lift Treatments】
・It's important to lift not only the skin but also the fat and SMAS (superficial musculoaponeurotic system).
・Aim for a natural finish by avoiding excessive lifting.
・Choose the appropriate lifting method based on the direction of the sagging.
Typical facelifts lift the skin laterally (horizontally), which can sometimes create unnatural tension.
In contrast, a vertical lift, which lifts the skin vertically, fundamentally addresses sagging caused by gravity and offers a more natural rejuvenating effect.
4. Why Combining Under-Hamra and Vertical Lift is Effective
POINT 01
Achieve balanced rejuvenation by lifting the eyes and cheeks together.
By combining the under-Hamra technique with a vertical lift, you can rejuvenate the area from under the eyes to the cheeks in a unified way.
【Benefits of Combining Both Procedures】
・Improve dark circles under the eyes while lifting the sagging cheeks.
・Achieve a more natural and youthful appearance with balanced eye and cheek rejuvenation.
・Reduce sagging of the lower face due to aging, increasing the overall rejuvenating effect.
Especially for those concerned about dark circles and hollows, combining the under-Hamra technique with mid-facial lift will help restore a more youthful impression.
5. Advanced Lift Techniques Offered by Dr. Nagura
POINT 01
Achieve your ideal face line and youthful appearance with Japan's top technique.

He is particularly known for his nationwide No.1 results in facial liposuction and thread lifts, and his exceptional skills also enable him to handle complex and revision surgeries.
【Reasons to Trust Dr. Nagura for Your Surgery】
・Overwhelming skill with 7 years of consecutive No.1 nationwide liposuction cases.
・Unique technique that minimizes downtime with short surgeries.
・Emphasizes a natural finish, offering personalized plans for each patient.
・Highly trusted by both staff and fellow medical professionals, with many healthcare providers requesting his surgeries.
6. Summary
POINT 01
Simultaneously improving the sagging of the eyes and mid-face to achieve balanced youthful appearance.

By receiving the appropriate treatment tailored to your individual condition, you can expect an ideal outcome.
Dr. Nagura has rich experience and a proven track record in such rejuvenation procedures and provides the most suitable approach for each patient.
If you're concerned, please feel free to consult with us for a consultation.
Liposuction FAQ
QUESTION 01
Is it better to have liposuction and thread lift at the same time?
The benefits of doing treatments at the same time are 〇〇!
The video explains it in detail, so please check it out.
QUESTION 02
Any internal bleeding or swelling?
・Swelling lasts for about 1 to 2 weeks
And it often heals. Downtime varies greatly from person to person, so it may be shorter or longer than the above.
In order for our customers to undergo surgery with as much peace of mind as possible, we have posted many realistic downtime periods on Youtube.
Please check it out!
QUESTION 03
Is there any pain?
Dr. Nagura performs liposuction with a high level of skill, so during the downtime you will experience mild pain similar to muscle pain.
We also provide painkillers, so if you are concerned about pain, we recommend that you take them.
QUESTION 04
How long does it take to finish?
Many people may be worried because the period will be different from the downtime period, but Dr. Nagura has produced solid results, so please wait with confidence.
QUESTION 05
How to care for contractures?
Massage is not recommended for those who absolutely do not want their skin to sag after surgery.
Instead, Dr. Nagura recommends ``neck stretches.''
QUESTION 06
What if you received liposuction at another hospital but were not satisfied?
In addition, there may be muscular or skeletal causes that cannot be cured with liposuction.
Dr. Nagura is a doctor who specializes in corrections, and is able to accurately determine the cause of dissatisfaction and make recommendations.
We have also posted the details of the modifications on YouTube, so please check it out.
If you are worried about correction, please consult Dr. Nagura, a famous facial liposuction doctor.
Dr. Nagura is now recruiting monitors for nasolabial fold treatment!
By providing photos, you can receive nasolabial fold treatment at a discounted price. We will work closely with each individual to understand their concerns and offer the most suitable treatment. Let's improve those nasolabial folds and achieve a natural, youthful appearance!
*Please note that you will need to visit the clinic after the procedure for photo-taking.
*Depending on your request and suitability, you may not be eligible for this monitor treatment. Thank you for your understanding in advance.
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