Cheek Lift or Fat Injection to Cheeks?

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Great question. Obviously a good exam by a boarded plastic surgeon is necessary. I am a big proponent of fat transfer to the face for my patients. It can help with fine wrinkle lines, improve cheek structure and improve the tired appearance of the lower eyelids. 

From what you said I would usually do the cheek lift or cheek implants depending on the size of your cheeks vs. Sagging.

I personally have done cheek lifts and fat trasferring many times. I feel that the cheek lift doesn't give you a natural look and really doesn't do the things you want it to do. It is my opinion that this procedure is outdated and not very useful in many situations.
 

Looking at you photos...I would recommend a cheek lift (endoscopic mid-face lift) for the most reliable, long-lasting and NATURAL result. Fat injections can be a useful substitute if  for whatever reason you can't undergo the cheek lift.  But, my first choice would be a cheek lift by someone experienced and who performs their midface lifts without an incision under the eye.  All the best, Dr. Vartanian.

I would recommend filler injection first. This may include Juvederm or Restylane that last anywhere from 6-12 months by a physician who is very familiar with filler injection into the periorbital ( around the eyes ) areas. This will allow you to see how you would like the result and if you don't, it will go away later and can opt for the cheek lift which will bring up all the fullness you have in your lower cheek up against your lower eyes.

It is good you are doing the research, but unfortunately this can only be answered with a physical examination.  See a surgeon experienced in these procedures. 

While only an actual examination can say for sure, it would be unlikely that at age 39 a cheek lift would be worth the effort and the risks associated with it. More likely, volume enhancement through fat transfer or implants would be more appropriate. Without question, however, fat injections are the easiest to do and have virtually no risk other than eventual loss of the injected fat volume.

You need a consult with a BOARD CERTIFIED PLASTIC SURGEON (AMERICAN BOARD OF PLASTIC SURGERY). To evaluate the skin quality and the face in general. You have flat chhecks and tear trough deformity. You may require both a face lift and fat transfer, depending on the look you want. Remember you have a full face adding too much fat may not be the most ideal.

Fat graft is NOT a substitute for a face lift

You maybe a candidate for a cheek lift or cheek fillers or possibly both, it is hard to say without an exam.