Am I good candidate for mid face or under eye fillers? 32 y/o concerned about volume loss in the eye and cheek area (photos)

Question

I am a 32 year old woman and noticed I've lost volume under my eye/cheek area, it appears more flat than other women in my family and other women friends. I'm looking to regain some volume and also feminize that part of my face again. See below for some pics of me about 3 weeks ago.

Jaime Haidenberg, MD · Answer

Hello,Volume loss in the midface is very common and may start as early as 30 years old. Midface volume loss may be a result of maturation and/ or weight loss, which includes fat pads separating, muscle laxity, bone degeneration and collagen loss. Revolumizing the midface is a game changer! By treating your cheeks alone, you may get the correction you need under your eyes by replacing the loss of volume. After your cheeks are corrected, then you and your injector can decide if under eye filler is a good treatment to add in order to reach your goals. Please make sure you always see a reputable nurse or doctor injector. Good luck in your journey!

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Nima Shemirani, MD · Answer

Hi @dontstartnow17! You would achieve great benefit from midface/tear trough fillers to help with volume loss and a more refreshed looked. My go to products I use for the tear trough area includes either Juvederm Voluma or Restylane Defyne.

Jonathan Kulbersh, MD · Answer

Thank you for submitting your question and photos. You appear to be a candidate for dermal fillers to treat midface volume loss. These hyaluronic acid formulas can restore lost volume to hollow cheeks and smooth the transition between the upper cheek and lower eyelid while sculpting midface contours for a supple and youthful result. I recommend scheduling an in-person consultation with an experienced, board-certified injector. They will be able to discuss your aesthetic goals with you and determine the best treatment option to help you achieve them.

Sam Speron, MD, FACS · Answer

Thank you for sharing these photos and this question. It can be confusing to try to figure out which procedure works best for the aging face and who to ask. Facelifting surgeries can usually be an option on most realistic patients anytime, it really depends on your anatomy and genetics. It is best to talk to your surgeon because everybody has different techniques and recovery time is usually based on a number of factors but there's no set number on age. Sometimes even younger people are candidates because of their anatomy or if they have gone through certain medical conditions.

Surgery is not for everyone though. In today's day and age, there are many nonsurgical options like laser treatments and injectables such as filler or neuromodulators to consider although surgery usually gets the most improvement specifically of the under eye and cheek area.

I would recommend that you see a board-certified plastic surgeon in your area that is a member of both ASPS & ASAPS and performs a lot of facelifts but also offers all the nonsurgical options such as injectables and laser treatments. Go over your concerns with them and make sure above all, you walk out of there with several options and an idea of the pros and cons to each of them as well as realistic expectations.

I hope this helps and wish you all the best in your surgery and event. If it does, please take a moment to up vote this answer on the “respond” button on the top right.

Nelson Lee Novick, MD · Answer

The upper cheek region is a major support area for the infraorbital (under eye) region. Volume deficit or loss in this area can lead to the development of under-eye tear troughs, hollows and bags. This same region is also important for facial contour. When there is volume deficit or loss, particularly in the upper outer cheek fad pad, the female face can lose its much desired oval, heart-shaped appearance. So, restoration of the volume in this critical area via the use of an appropriately robust HA filler properly injected by an experienced injector can not only restore the more ideal contour of the female face, but secondarily improve the under-eye region. Thje results of this filler approach are typically immediate and evoke an immediate "Wow!" reaction. You would be wise to consult with a board certified cosmetic dermatologist and best of luck.

Robinson Facial Plastic Surgery - Alpharetta · Answer

Hi there! Thank you for your question. You are a beautiful woman, but yes, it appears as though you have lost a little volume in the mid face and in the tear trough, which is creating a darkening affect in that area. I would recommend starting with a small amount (1 syringe) of filler to the medial cheek/tear trough, and see how that looks. The goal is to soften the cheek/lid junction and give that area a brighter, more youthful appearance. This is a delicate area, so make sure to choose a provider that has lots of experience working with the tear trough. Good luck!

Melissa M. Chan, MD · Answer

Your undereye area has some volume loss and by using fillers every 6 months or so, you can maintain a more youthful appearance by using soft fillers.

Camille Cash, MD · Answer

Though an in person evaluation is always best, it appears you are a candidate for fillers.  There are different types of fillers that are designed to best treat certain areas (ie a special formula great for the cheeks, a different one for under the eyes, etc).  Be sure to see an expert injector for a consultation.

Kenneth R. Francis, MD, FACS · Answer

Dear dontstartnow,
Although 32 is a relatively young age to start losing facial volume, for whatever reason, be it genetic, weight loss, or aging, you appear to have done so.  There are many, many options for facial revolumization today, each with its advantages and disadvantages.  They range from surgical simple fillers, to more complex fillers, to surgical fat grafting.  Seek consultation with an American Board of Plastic Surgery board certified plastic surgeon for an examination and discussion of all of your options.  Good luck!

Am I good candidate for mid face or under eye fillers? 32 y/o concerned about volume loss in the eye and cheek area (photos)

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