Do you think facial fat transfer to the cheeks would be a good solution for my malar creases? (photos)

Facial fat or fillers for the young patient? NO FAT!!!! It is not reversible except with surgery!A filler such as Voluma which is reversible is what I would suggest.

Fat transfer is one option, keep in mind the results are permanent, but not all fat will survive. Harvesting is the key to fat transfer. I use water-assisted fat harvesting which gives pure fat to transfer and combine with platelet-rich plasma (PRP) to get the most viable, sustainable fat cells. This can be combined with Sculptra, depending on the treated area, to improve outcomes. You could also get really great results by using fillers for your volume loss. I recommend getting a formal evaluation with a fat grafting expert. Best, Dr. Emer

you are correct in your analysis.  Your maxilla lacks forward projection and restoring the volume in this area would help your aesthetic looks.  Fundamentally this is a skeletal shape issue.  The treatment options are  facial implants, a mid face lift( very different than regular facelift) fat transfer or filler's.  Of these fillers it's probably the easiest, most predictable and  consistent.  The volume and where it's placed can be adjusted over time to get the ideal look.  The recovery is typically minimal and it doesn't require any type of surgical intervention.  Check out the results of Dr. Marbie in San Francisco. His practice is called your face in our hands  he gets some of the very best results from mid face fillers of any provider I've ever seen.  He does not do fat transfer or other surgical procedures though he is trained in all of them.  Fat transfer may seem preferable because it's permanent. Compared to fillers it's highly inconsistent and unpredictable. You can leave to very difficult situations if more fat survives in undesirable areas or you develop fat necrosis with hard nodules.  Implants are used less often today because of alternatives which are preferred by patients such as fillers and fat transfer.  Still, well-placed implants can do great and really treat the underlying skeletal balance issue spot on.  Amid facelift is highly invasive but can give permanent consistent results. The recovery is challenging and most patients prefer not to have this procedure.  The procedure basically separates the soft tissue from the mid face skeletal structures and lifts the soft tissues up words creating a new sense of fullness where needed.  The procedure can be done and a scopically through the scalp or as an open incision procedure. Dr. Elam in  Orange county has some spectacular results of this procedure.  Personally I would put fat transfer quite a bit lower on the list of choices. By far my preference would be long lasting fillers like Voluma or Radiesse.  If you're happy with the results from providers using these products then you can switch to even longer lasting fillers like Bellafill. Best, Mats Hagstrom MD