My Face Was Full But Lost a Lot of Volume and Midface Became Flat. Cheek Implants? Fat Graft? (photo)

My face was full but lost a lot of volume and my midface got flat. I had buccal fat pad removal 10 years ago and I'm more than convinced that's the reason. Looking into cheek implants to restore my face. I hear often that implants may look unnatural after a couple of years. Are there any remedies/procedures to prevent or fix this? How unnatural can it look? I know fat grafting is recommended instead but I'm afraid it wont provide enough volume or the defined look I used to have.

Doctor Answers 10

My Face Was Full But Lost a Lot of Volume and Midface Became Flat. Cheek Implants? Fat Graft?

 From the photo, your cheeks are flat with the left more flat than the right.  Fillers like Perlane or cheek implants can be used for the cheek augmentation.  I don't use fat transfer for facial shaping or contouring as IMHO, it's far less reliable than fillers or cheek implants.  be sure the plastic and cosmetic surgeon, you select, understands and follows the proper aesthetics of facial beauty for the creation of a naturally, more attractive face.  

Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Injectible fillers and fat grafting...can both be helpful

Fat grafting  would be the ideal technique for you for a long term result, but you can start with fillers to see what type of improvement you can get, and whether you will be happy with that.

I have often seen implants removed over time because of unnatural long term results.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 41 reviews

My Face Was Full But Lost a Lot of Volume and Midface Became Flat. Cheek Implants? Fat Graft? (photo)

My choice would be fat grafting by the Coleman techniques. most likely 30 to 50 cc's injected in droplet fashion. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Cheek Implants vs Fat Injections for Flat MIdface

Either cheek implants or fat injections can help restore midface volume but they are very technique-dependent. Properly sized and style of cheek implants can look very natural if they are not overdone and do best at creating good cheek definition. Fat injections or injectable fillers can provide overall volume but are not good at creating well defined cheek highlights and their volume retention is either unpredictable or unsustained. There are advantages and disadvantages to both approaches and neither one is perfect. 

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Cheek implants

Based on your picture I see what is called scleral show and I wonder if you ever had lower eyelid surgery or you may in fact have maxillary hypoplasia. Done well implants or fat grafts grafts are good long term solutions. Fillers work well and are more adjustable but need multiple treatments over time. I hope this helps, please see board certified plastic surgeon who can guide you.

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 59 reviews

Flat face with volume loss.

One of the advantages of performing surgery for 35 years is seeing your results over years.properly done cheek implants will not look innatural decades later IF you do notable them too big. I also never do buccal fat removal for the reason you mentioned as well as others. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

How to restore Facial Volume?

Surgery is not great at restoring volume, cheek implants can look good initially but often do not age appropriately with the face, I recommend either natural volume restoration like Fat grafting, or fillers such as Radiesse or Sculptra, I do not use HA fillers in this area as I feel they give a "hard" look in this area, although they are very useful in other areas!

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 87 reviews

Replacing lost volume in the midface

Longer lasting fillers such as Radiesse and Sculptra have many advantages over cheek implants. One obvious advantage is that surgery is not required. Another is that you can get either a rapid or a gradual correction depending upon how many syringes you have injected and you can decide as you go exactly how much correction looks good. Another advantage is that cheek implants may no longer look good in an aging face as it changes over the years. Touch up treatments for fillers can be modified over many years to better fit the aging face.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

Fat Loss in The face

Removal of the Buccal fat pad is the reason you seem to have lost volume in the face.

You seem young, and very attractive facial proportions. If you insist on doing some thing, then minimal amount of work. may be a small amount of fat transfer. No cheeck Implants

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Cheek implants great option to restore volume to flat mid-face

Cheek implants have an excellent track record of augmentation of the cheek area.  Surgeons get very consistent results with implants and very inconsistent results with fat grafting.  The cheek implants are made of silastic and are available in different sizes and shapes, such as malar and submalar.  The correct size and shape of implant is determined during the consultation appointment.  Cheek implants are inserted through a small incision at the upper gumline intraorally, placed directly over the bone, and usually under a brief general anesthesia as an outpatient procedure.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.