Whats causing cheek indents near nose? What's solution? (Photo)

Question

Have had tear troughs w restalyne silk & dysport on crows feet (and bunny lines 2 attempt 2 fix this). Never had these indents prior. Is it overfill on tear troughs?

Harold J. Kaplan, MD · Answer

Helllo,We are curious how this area appears when you are not smiling.  However, based upon your history, it appears that you may have had the filler placed too far below the tear trough area which is allowing for it (filler) to create these bulges. Hence, the changes to the cheeks.  Besides incorrect location, you may also be over-filled.  As Dr. Emer suggested, you may have this reversed/dissolved using hyaluronidase.  We have corrected many poor "tear trough" treatments from outside of our practice for similar outcomes. Please see the below link for additional information.Regards.

Aldo Guerra, MD · Answer

Thanks for posting your photos. I cannot tell the exact cause, but it is likely swelling or overfill or appropriate fill without fanning into the cheek. I suggest you see your injector and have an examination of the area.Best wishes, Dr. ALDO

Christian G. Drehsen, MD · Answer

These deep creases are the result of an hyperactive muscle that uplift the lip too widely. Some careful Botox or Dysport injections can reduce the exaggerated gummy smile and deep creases.Christian Drehsen, M.D.

Kenneth Bermudez, MD, FACS · Answer

Indentations at the junction between the cheek and the eyelids are usually due to lack of tissue (fat, subcutaneous tissue and bone). It gets worse as you age due to the loss of volume of the bone just underneath.It can be genetic or happen due to massive weight loss or age.There are both surgical and minimally invasive options. The most common is the use of fillers as you have had.Unfortunately, it's difficult to tell you what happened, especially since your pictures are with you smiling.You can always have the filler removed with a substance called hyaluronidase. Best of luck.

Jason Emer, MD · Answer

This is tough to answer without a before and after picture. If you're unhappy with your final results with Restylane, you can have it reversed with hyaluronidase and try a different technique next time. Keep in mind, a combination approach is needed to get the most improvement in this area. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. EmerSee an expert. Best, Dr. Emer

Monika Soni, MD · Answer

This is tough to answer without a before and after picture. If you're unhappy with your final results with Restylane, you can have it reversed with hyaluronidase and try a different technique next time. Keep in mind, a combination approach is needed to get the most improvement in this area. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals.

Whats causing cheek indents near nose? What's solution? (Photo)

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