Cause and Treatment of Indentation Below the Tear Trough? (photo)

Question

I've just turned 21 (though my gaunt face makes me look a bit older) and I've recently developed an odd indentation just below the tear trough. It's in between the tear trough and the nasolabial folds. You can see it in the photo (sorry about the low quality). To me it appears like the fatty tissue has simply started to atrophy, but I'm not a doctor. Is there any precedent for treating something like this?

Trevor M. Born, MD · Answer

Dear guywithaquestion

	Thank you for your question!

	It is a little difficult to tell from your photo- the exact nature of the contour change. It can be related to the lymphatic outflow around the eye or due to local volume loss. Options for soft tissue contour near the eye are RESTYLANE and Micro Fat Grafting. If this is related to the lymphatics I would be careful about having procedures done in this area.

	With Warm Regards,

	Trevor M Born MD

Kenneth D. Steinsapir, MD · Answer

This may be a so-called pillow line from smushing the face at night with a pillow.  This represents a change in volume in an area where the midcheek groove develops.  Hyaluronic acid fillers are immensely helpful in dealing with these sorts of issues.

Francis R. Palmer, III, MD (retired) · Answer

From the photos, you have indentations and relative flatness of the anterior (front section) of the cheeks.  This aesthetically makes the face appear elongated and rectangular instead of the preferred heart-shape for females.  IMHO, the best solution would be for you to have Cheek Augmentation using a filler like Perlane or Radiesse so  you can see the Aesthetic improvement.  Permanet Cheek Augmentation could then be achieved using Cheek Implants if so desired.

Cause and Treatment of Indentation Below the Tear Trough? (photo)

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Cause and Treatment of Indentation Below the Tear Trough? (photo)

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