Sagging cheeks, under eye hollowness - am I a good candidate for cheek augmentation? (Photos)

Question

Hi I have been dealing with this sagging face look for a very long time, it’s genetic I presume. My cheeks are sagging I have under eye hollowness and lack of fullness in the upper face. Am I a good candidate for cheek augmentation or should I do fillers first ? Also I don’t like the bulging eye look of the lower lid when squinted.

Anna Chacon, MD, FAAD · Answer

For addressing sagging cheeks and under-eye hollowness, you might consider the following:

Cheek Augmentation: If you are seeking a more permanent solution, cheek augmentation with implants can provide significant volume and lift to the mid-face area. This is suitable if you desire a long-term enhancement and are comfortable with a surgical option.

Dermal Fillers: Starting with dermal fillers can be a less invasive way to add volume to the cheeks and under-eye area. Fillers can help lift sagging cheeks and fill the hollowness under the eyes, providing a more youthful appearance. They offer the advantage of being reversible and adjustable.

Combination Approach: Often, a combination of fillers and cheek augmentation can yield optimal results. Fillers can be used initially to gauge the amount of volume needed and to see how your face responds to added volume, which can guide further treatment decisions.

Lower Eyelid Concerns: To address the bulging appearance of the lower eyelid, options such as skin tightening treatments, lower eyelid surgery (blepharoplasty), or targeted fillers can be considered, depending on the underlying cause.

Consulting with a board-certified dermatologist or plastic surgeon can help determine the most suitable approach based on your specific facial anatomy and aesthetic goals. They can provide a comprehensive evaluation and recommend a tailored treatment plan.

Chet Mays, MD · Answer

Thank you for your inquiry! By your photos, you're a great candidate for filler or fat transfer to your tear trough to help fill the hollowness. We would love to meet with you in person. Schedule a consultation with a Board-Certified Plastic Surgeon like myself to help you reach your goals and create a plan.

Jacob Tower, MD · Answer

Hello, hope you are well. Thanks for posting your questions and photos! What appears to be 'sagging' is more likely due to inadequate submalar volume. I suspected your cheeks would look relatively flat if we had a profile view of your face. Cheek implants are an excellent way to compensate for that type of volume deficiency. Fillers are a reasonable alternative, but highly dependent on your injector--the amount, placement, etc can be highly variable depending on who you see. Fillers are also temporary, the material can migrate/disperse, and by comparison to implants, fillers are not the appropriate material to "lift" the cheeks. Hope this helps!

Best,
Dr. Tower

Best,
Dr. Tower

Michael P. Morrissette, DDS, FACS · Answer

The flat area is most noticeable below your eyes. I would recommend filler initially to see how you like the aesthetics. If you like the results, then the best long-term solution is submalar (cheek) implants.

Nelson Lee Novick, MD · Answer

Since the upper mid cheeks are a major structural support for the under eye regions, the use of an appropriate HA volumizing filler properly injected can not only improve volume deficit in the cheeks, but secondarily improve under-eye hollow and tear troughs, but also provide enough lift to secondarily improve the smile lines You would be wise to consult with an experienced, board certified cosmetic dermatologist filler expert, since male cheeks must be volumized differently than female cheeks in order not to inadvertently feminize a male face. Hope this helps and best of luck.

Sagging cheeks, under eye hollowness - am I a good candidate for cheek augmentation? (Photos)

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