Facial hollowing: an early sign of facial aging?

Lavinia Chong, MD answers: Facelift or Fat transfer for lower cheek fat loss?

I am 37 years old, and my problem area is my lower cheeks. Is it time for me to have a facelift or would fat grafting be enough?


Lavinia Chong, MD
1 month ago

Oxana, from the photo submitted you have a lot of advantages: excellent facial skeleton, preservation of fat in the midface (upper cheek), lack of mandibular jowls, full lips and unblemished skin. Many women in their mid 30's experience some facial fat lipoatrophy, as we struggle to keep our bodies toned.  You could consider surgery, however from what you've shown, your early sign of facial aging is relatively minor and as such can be treated by dermal fillers such as Juvederm Ultra Plus or Perlane. Assuming that you are in Russia, you may even have access to Voluma (a longer lasting Hyaluronic acid filler).  By balancing the hollows in the lower cheeks, you can simulate a younger, fuller face and compliment your lips.

Structural fat grafting is a powerful technique, however it does require an operation with subsequent recovery.  Almost every woman will agree to fat grafting, however in my experience, the technique is most successful in individuals whose weight is "normal"; their fat grafts persist 3-5 years. By contrast, very thin patients and/or vegetarians tend to experience less longevity. 

Facial surgery is more appropriate for individuals whose facial features have more pronounced stigmata: mandibular jowls, looser skin, diastased neck bands, global hollowing.  You're not there yet.  good luck.

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