I have dents in my cheeks. I am in my late 30s and it seems pretty early to have blepharoplasty or a cheek lift. However, I want to minimize or ideally get rid of them because they look awful and make me feel bad. A facial plastic surgeon friend told me that he didn't recommend fillers since the cheek pads are hard to augment.
What is Recommended to Get Rid of Cheek Dents?
Doctor Answers 17
Several options to correct cheek dents
There are several good options to correct depressions in your cheek. To get a great result, your surgeon should first evaluate what the causes of the dents are. If these are normal dimples, they may be filled with a dermal fillers such as Restylane or Juvederm. If these dents are from scarring or disease such as chickenpox or acne, you may be best served either with a dermal filler or by releasing the deeper fibers that are pulling the skin down.
Midway in the cheek, there is a set of ligaments effectively forming a barrier to downward flow of fluid. It is the reason patients form black eyes if their eye is injured, and the reason the bruising often stops exactly at a semicircular line on the cheek.
This anatomic boundary is difficult to defeat.
For younger patients such as yourself, hyaluronic acid fillers (Juvederm, Restylane) work very well.
For patients with a more pronounced problem, we can perform a superficial cheeklift.
However, it would be premature to perform such a procedure in a young patient with so minimal a problem.
All you need are fillers
You don't need a lower blepharoplasty. You have some specific volume deficits that are a family trait showing up early in you. Well done Restylane by an experienced plastic surgeon will help you avoid surgery for years and will give you a rejuvenated look that eyelid surgery in your case isn't as capable of doing.
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You will need lower blephoplasty and cheek lift
Looks like you have fat pockets under your eyes and you have two options
1)filler to camafloge the dent
2) lower blepoplasty ( you will need check lift with this and if you get only fat pocket removal you will have the same issue down the road)
The cheek lift with lower eyelift is some thing that not all plastic surgeons offer.
Fillers will work but must be injected deep
I would highly recommend fillers for this specific problem. The cause of these dents is a mild descent of midface tissues around the deep bands attaching the dermis to the bone (Osteocutaneous ligaments). The droopy tissues pull on these deep bands causing these dents.
Since it is mild I would not recommend a full cheek lift but filling.
The choice of filler and technique is a very important issue. This is not similar to injection of nasolabial fold or tear trough. Injection must be done deep as these bands are not superficial. Micro fat technique is my procedure of choice but other fillers could work as well.
I hope that helps, you can view similar cases injected with fat on the practice webpage.
What's recommenede for cheek dents?
From your photos, the cheek dents would not be reduced, or effected by eyelid surgery. A cheek lift would lift all the cheek area and most likely raise the entire cheek fat pad, including the dents, upward. Your best bet, IMHO, is to place a filler like Perlane in the dent to smoothen it out. Sculptra could also be usde for a result that could last for about 2 years. If the cheeks were flat, which they do not appear to be, a cheek implant would permanently correct the dents, IMO.
Radiesse is an Excellent Treatment for Cheek Dents
The unique viscosity and elasticity of Radiesse allow it to be molded to minimize irregularities in contour. Radiesse will stimulate collagen production which then will have a nice, long lasting lifting effect for these dents. Radiesse is comprised of calcium-based microspheres suspended in a water-based gel. The gel carrier causes immediate correction and is gradually absorbed. The calcium particles act as a scaffold for new collagen formation around the microspheres. This fixes the particles in place discouraging migration. Radiesse reportedly lasts 12 to 15 months. A booster injection 3 months after the initial injection will usually prolong the duration of Radiesse for 15 to 18 months. After that Radiesse can be repeated as necessary.
Fillers for cheek dents
Fillers such as Restylane or Perlane help with filling in the dents of the cheeks. The filler works well in adding volume to the deficits of the cheeks. Make sure you go to an experienced injector that is familiar with this area that you are concerned with.
Juvederm or Restylane good for cheek dents.
From your picture, I would say the little dents in your cheeks can be easily corrected by injecting a little Restylane or Juvederm just under the skin. The result should last at least nine months.
Radiesse or Sculptra better option for cheek depressions or 'dents'
The conservative approach for cheek depressions or 'dents' is dermal fillers. Radiesse (made of fine calcium granules) is the best short-term solution. Sculptra may be the best long-term solution as it may last 2 to 2 and 1/2 years though it may require 2-3 injections.