Tanuj Nakra, MD

 

You have strong bone structure, perhaps accentuated by your orthodontic work.  In my opinion, additional implants to add volume will look unnatural by further increasing the solid mass of immovable deep structure in your face.  However, you are right in your assessment that you have some gaunt characteristics, especially in your tear trough area and lower face.  Soft tissue volume, such as autologous fat transfer might help to restore facial harmony by increasing dynamic volume.  You could always "step in to the dressing room and try it on" by having a surgeon inject saline into your face so that you can see the actual effect of soft tissue volume.  The saline is absorbed within a few hours, so it is a short & sweet reversible experiment.  Synthetic volumizers are an option as well, but you may want a more longer lasting option, such as fat, since your problem is not the need for rejuvenation, but a real lasting change.  Having said that, synthetic fillers can offer you a one year trial of volume before you take the plunge into autologous fat.

 

Good luck!