Fillers or cheek lift? (photos)

46 yr old male. Trying to figure out if I need fillers around eyes and cheeks, or if I need a cheek lift. Under eye area looks hollow and haggard although I'm not tired. The thought of going back for fillers over and over doesn't thrill me but if it works, it may be worth it. Upper lids are just a little droopy but not bad yet. In good shape, I work out 5 days a week so I don't have much fat.

Doctor Answers 8

Get Fillers

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The eye-cheek junction is a common place to lose volume. A cheek implant will not really help this area. Base on your photos, fillers to the eye-cheek junction would improve the contour of that area-thus, making you look less tired.  Eventually, you may start to lose more volume from your cheek area and need an implant then, but for now I don't think you would benefit from a cheek implant.

Dallas Facial Plastic Surgeon

Fillers or cheek lift?

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Juvederm UPXC® or Juvederm Voluma® are ideal for filling in "tired-appearing" under eye hollows and shaping and enhancing cheeks in this people. Results typically last 1-2 years.

Manjula Jegasothy, MD
Miami Dermatologist

Cheek lift vs. Fillers

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Fillers like Radiesse, Voluma, Perlane work great for cheek volumization which helps improve the nasolabial (smile lines) as well indirectly. Long term my patients also get Sculptra injections to help stimulate collagen and make the filler last longer. Fat can also be used which is something I do frequently in my practice. I suggest a formal consultation for facial rejuvenation for both long and short term improvements. Focus on someone who treats a significant amount of men. Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

Midface deflation

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A staged approach with volumizing agents (hyaluronic acid and biostimulatory fillers) can offer a natural and more predictable outcome, and this is key for male facial rejuvenation.  Implants will not be able to address the eyelid-cheek junction contour and infraorbital volume changes. Mild Botox of the eyelid depressors will reduce the frowing lines and lift slightly the lateral eyelids. 

Costas Papageorgiou, MD, FACS
London Oculoplastic Surgeon

Filler or lift?

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You would benefit from some volume in your face. That can be accomplished with fillers, fat grafting or facial implants. There are advantages and disadvantages to each method. You would likely be very disappointed if you had a procedure to lift your midface without adding volume.  You should make an appointment with a board certified plastic surgeon to explore all you options.

Sonya Merriman, MD
Valdosta Plastic Surgeon
5.0 out of 5 stars 7 reviews

Fillers or cheek lift?

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Thank you for sharing your question and photos. It appears you are a great candidate for dermal fillers to the midface and tear troughs. In my practice, I have had great results using a filler like Restylane Lyft or Juvederm Voluma to restore lost volume in the cheek area. I would also recommend tear trough filler, such as Restylane, to improve the appearance of the hollows under your eyes. With regards to the mid face sagging you are noticing, you are a great candidate for a procedure called NovaThreads, which are absorbable PDO sutures that are positioned beneath the skin to lift sagging facial tissue. This is an office-based procedure with essentially no downtime. The results last at least 6 months, at which time the procedure can be repeated to maintain the lifting effect. It does not appear that you are a surgical candidate just yet so it may be worthwhile to maintain with non-surgical procedures at this time. I recommend consulting with a board certified specialist who performs these procedures in order to get more information about the best treatment options for you. Best of luck. 

Kian Karimi, MD, FACS
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 73 reviews

46 yr old male. Fillers or cheek lift?

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Hi, I have performed many facial shaping and facelift procedures over the past 30 years. From the photos, your cheeks are quite flat, the chin is weak as are the mandibular angles and "jowls" are present.  These combine to create an elongate rectangular face.

Based upon the beauty principles outlined in my book on face and body beauty, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles. A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin. Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face. I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective. The following procedures would create a more ruggedly handsome face.

  • Cheek augmentation with cheek implants to add angularity to the cheeks and mid face. 
  • Chin augmentation, using a chin implant, to add projection to the chin creating harmony and balance to the lower face.
  • Augmentation of the mandibular angles using a dermal filler (jaw implants have too many unwanted side effects IMHO) to add volume, angularity and flare to the jaw line.
If you'd like the "jowl's" reduced, a minimally, invasive SMAS facelift could also be performed as described below.

If you have "jowls" this is sagging facial tissues and an indication for some form of a facelift, not Cheek Augmentation. I have performed many Cheek Augmentations over the past 30 years and the notion that Cheek Implants or dermal fillers to the cheeks, by themselves, will lift tissues is an urban myth. Filler to the cheeks or cheek implants will shape the cheeks but alone will not lift up the jowls. The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last). The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face and subperiosteal facelifts) but with these added benefits:

  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine whatever facial shaping that's necessary with every facelift procedure. When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

fillers versus cheek implants

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 Fillers offer a temporary augmentation to the cheeks that are usually performed in the office setting. Depending upon which  fillers are being used will determine how long the augmentation lasts. Cheek implants offer a permanent augmentation to give the necessary volume replacement to the mid- face. Cheek implants are manufactured in a large variety of shapes and sizes, are composed of Silastic, and are placed through an intraoral approach under brief general anesthesia as an outpatient surgical procedure. For many examples of cheek implants,  please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 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.