Can Fat Transfer Be Used to Create Sculpted, High Cheekbones?

You are correct. Fat transfer I believe is a great way to help correct asymmetry of facial soft tissue deficiencies as well as to augment the cheek bone area giving the illusion of high cheek bones. It is a great technique with long lasting results which can be added to when there is continued loss of native fat in this area as part of the aging process. Of interest the transfer fat that survives tends to stay better than the native fat as it retains the nature of the donor site rather than the recipient site. Since the advent of fat transfer the number of implants I use and recommend has decreased significantly as this is such a good technique. 

Yes, fat grafting is one option.

 

Alternatively, you could use "off-the-shelf" fillers - like Sculptra or Radiesse.  They are both quite long-lasting, and woundn't have the downtime of a liposuction / fat transfer procedure, and are a bit more predictable in terms of symmetry and outcome.

Fat grafting can be used to create higher cheekbones. Customized placement can lead to a more heart shaped appearance like you describe.