Is the dent on my cheek a Malar bag or a sunken cheek? Needing solutions! Melbourne, Australia (Photos)

Question

Hi I'm a 31 year old female and have noticed a worsening "dent" in my left cheek only ! It looks like a malar festoon up the top and then sinks in . I've noticed in some lighting it can look like the cheek is sagging ? Looking for a solution and what I can do to find out what's caused it.

Jonathan Kulbersh, MD · Answer

Hello, and thank you for providing photos along with your question. Only a personal evaluation can determine the cause of the dent on your left cheek. Malar bags may be caused by loosening muscle, fluid retention, fatty tissue, or excess skin –that’s why it’s best to have it checked in order to recommend the appropriate treatment.

Whether it’s a malar bag or a sunken cheek, you have several treatment options. Dermal fillers can help restore volume and raise the skin, while laser resurfacing can stimulate collagen production to tighten the skin and address skin laxity. You may also opt for cheek implants to fill in the area and give your skin a lift.

To know the cause of the dent and to determine the best procedure, schedule an in-person consultation with a reputable board-certified facial plastic surgeon. Your surgeon can assess your skin, determine the best procedure or combination of procedures, and ensure the best possible outcome.

Jason Emer, MD · Answer

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.

Timothy Osborn, MD · Answer

Firstly, I would recommend getting evaluated for "coup de sabre" or "scleroderma" and work from there. There may be a different treatment path if that is the case. Once you are cleared however, there are a few options for improving its aesthetic appearance. Filler is a quick option to add some volume to the area. The downside is that it would need to be touched up semi-frequently. More permanent options would be a small fat transfer (to add volume to fill the space), or cheek implants. An implant would lift the skin, creating a tighter space and making the hollow area appear filled.

Leonard Grossman, MD · Answer

First and foremost, you should look at the pictures of your face from years ago and determine if that area of hollowness was present there earlier. If it was, I would consider having a fat transfer into the area which should provide you with a permanent and a natural result. Make sure that the hollow area is not anything new. I hope this helps and good luck from New York City Plastic Surgery

Edmond Wood, MD - Account Suspended · Answer

Do you sleep on your left side? If so, try to sleep on back, always. This is called a nasojugal groove and is typically associated with deep malar fat pad atrophy (lessened volume) and gravitational descent, possibly compounded by side sleeping. A number of treatments are used, the easiest and usually sufficient is filler. A high cross-linked filler is deposited deep right at the cheek bone apex and in the groove. If worse, may need additional deep filler injection into malar fat pad. Other options may be thread lift to reposition descending tissue to more youthful position. Neither should be prohibitively expensive. Hope this helps!
EdWoodMD

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Have a consultation with an expert injector.  They should be able to add some volume in this area and stimulate collagen.

Best of luck!

Robert T. Buchanan, MD (retired) · Answer

The infra lateral malar area is a frequent area of volume loss in older individuals. Why you have it and only on one side would require an in person evaluation. If it is just volume loss, then use of a filler or fat to replace what has been lost is quite easy for an expert. In this area with no underlying bone to support a deep filler, anything injected needs to be placed mainly in the superficial compartment. Because of the multiple facial septi this has to be done very carefully to prevent a lumpy appearance.

Is the dent on my cheek a Malar bag or a sunken cheek? Needing solutions! Melbourne, Australia (Photos)

Answers (7)

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