What are these lines on my cheeks and how do I get rid of or lessen them? (Photo)

Question

I'm 21 years old and in excellent shape and health. I've always had chubby cheeks and these terrible lines. It's rare that I can take a decent picture without them showing. Any suggestions or clue as to why I have them?

Jason Emer, MD · Answer

this is common and can be improved with fillers. some people do not have the anatomy to support the volume on top and you need filler or an implant to give the shape back.  I suggest you see a cosmetic dermatologist with experinece in treating younger patients.  Best, Dr. Emer.

Gidon Frame, MD · Answer

The crease area between the cheek bone (malar prominence) and the soft tissue (skin, fat, muscle, connective tissue) is a common area which is usually genetically determined to deplete in facial volume.The facial tissue recesses creating a separation in the soft tissue from the bone, making the contour line appear dark. This volume recess can be corrected with filler. Usually filling on the peak of the bone to address the loose skin and then volume in the crease to disguise the flatness in this area. Attending to this concern earlier in your life achieves better long term outcomes. Sculptra can also help you build natural volume in these areas as this space on the face often requires a lot of filler to achieve satisfactory results.

Chaitali Nangrani, MD · Answer

Simply put, the lines on cheek are from volume loss, sun damage and crows feet, all part of the aging process. I would start with Botox, depending on what volume loss I see. I would then correct volume loss.

Michelle R. Yagoda, MD · Answer

Dear Tommianne,Those diagonal lines appear to be a result of the way your cheek fat is positioned to protect your cheek bones.  There are two ways to address this issue.  The fastest, easiest and most instantaneous way is to have filler placed into those areas.  An alternate method may be a surgery to lift the fat a bit higher, but you would need a consultation in order to address this option more fully.I hope this helps!Dr. Michelle Yagoda

Michele S. Green, MD · Answer

The line that you are describing is the fat that is absent from that area.  This is one of my favorite areas to inject.  A small amount of Voluma or Restylane Lyft can be added to that area and have a beautiful result. Best, Dr. Green

Edwin Ishoo, MD · Answer

This is a common line between two facial compartments and it can be improved by skillful injection of soft tissue filler.

Jo Herzog, MD · Answer

I am tuned into this because I have these creases and have had them my whole life. My 11 year old has them. A deep filler such as Radiesse, Restylane Lyft or vooluma, topped off with a softer filler such as Restylane will do a goos job on these . Be sure that you go to a very experienced doctor as these are not easy to tackle.

Darryl J. Blinski, MD · Answer

These malar/tear trough lines are genetic and weight dependent. Try HA fillers to the area for best results.....

George C. Peck, Jr, MD · Answer

Genes, genes, genes!!!The crease is a anatomical line between the cheek bone (malar prominence) and the soft tissue (skin, fat, muscle, connective tissue). As the soft tissue droops or sags even a little, there is a separation of soft tissue from the bone, making the crease line more distinguishable.This crease is much more common in older patients and in patients with significant weight loss. Over time the volume of the facial bones decreases, which takes "air out of the ballon" and accentuates  the "sagging" of the soft tissue, making the nasolabial folds deeper and the crease between the malar bone and soft tissue more noticeable.A small amount of hyaluronic acid in the crease or below the crease usually helps. In more severe cases, poly lactic acid (Sculptra) or fat graft transfers help modify the crease by adding volume and tightening the skin.Unfortunately you are very young to experience this problem. In my experience, the crease gets worse with age. Best wishes!

Kimberley Lloyd O'Sullivan, MD (retired) · Answer

Unfortunately, you are aging!! That is one of the first signs of aging and it is easily correctable. My favorite thing to correct this line is with injectable filler such as Radiesse or Restylane.  Both of these products are controllable and produce an excellent result by eliminating the shadow. The ideal correction is the bring the fold to neutral- no shadow.  The Radiesse lasts up to a year and the Restylane only 6-9 months. The choice depends on the skin quality as Radiesse is heavier and more effective in holding up thicker skin.  The Restylane is clear and better for more superficial injections.  It is hard to tell but it is not clear that this is fat herniation from behind the eyelid which would be treated with a lower eyelid blepharoplasty.  You would need to be seen to assess this.  The lower eyelid blepharoplasty is a long term fix if this is truly fat herniation but I suspect this is more related to the deflation and sagging of the cheek than the fat herniation at this age.   Exam will tell.  Either way, you have great options and most likely you would be thrilled with the effects of the injectable because you walk out of the office with 100% correction and you look good and feel good immediately.

What are these lines on my cheeks and how do I get rid of or lessen them? (Photo)

Answers (12)

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