Best Option to Fix Hollow Midface Look?

Question

I am a 21 year old male and want to fix the sunken look I have in my midface area. What would be the best procedure to get rid of the hollow lines (wich I call railroad track lines) in my midface? I have read about filler injections but they are only temporary and leave a plump, round shape which I dont want. I would like to have a more narrow/angular look. Could cheek implants work?

Michael Constantin Gartner, DO · Answer

Cheek implants may help, but I think you should consider fillers since at your age it can help smooth away the hollowness.

Babak Azizzadeh, MD, FACS · Answer

There are actually many options to correct your hollow midface. One is Sculptra, which is an injectable filler but can last up to 3 years. Cheek implants are an option. I would consult with a surgeon who offers both and he/she can discuss pros and cons of each.

Mark Hamilton, MD · Answer

As our understanding of aging has improved, facial plastic surgeons have come to appreciate how a hollowed mid-face can really give an aged, tired appearance. Options to correct this include both temporary fillers as well as surgical implants.

A variety of fillers can be used to fill the cheek. Options include Juvederm, Radiesse and Sculptra. These fillers can provide correction for anywhere from 9 months to several years depending on the choice of filler, technique and number of sessions.

For those looking for a more permanent solution, surgical implants are a great option. Implants can be placed through small pockets made on the inside of the mouth during a short surgical procedure. These implants are typically made from either solid silicone or GoreTex, both of which have a proven  and safe track record. Discussion of which options are best for you can be done during consultation with your facial plastic surgeon.

Houtan Chaboki, MD · Answer

Sunken cheeks may be due to multiple factors and not necessarily from age alone. First line options typically include office injections, such as Radiesse or Sculptra. These particular injections are "semi permanent" and will require repeat treatments periodically.

	Cheek implants are another great option. Silicone cheek implants are the only permanent method for midfacial enhancement. There isn't a best option, but rather many good options based on your specific goals and facial anatomy. Only after a comprehensive evaluation can a specialist help determine appropriate options for you. Best of luck.

	Dr. Chaboki

Jenifer L. Henderson, MD · Answer

There are actually lots of options to improve the mid face region. Temporary measures include: Sculptra, HA fillers (Restylane, Juvederm), and Radiesse. More permanent options are: placing cheek implants (there are a variety of sizes and shapes), fat injections, and a surgical mid face lift. Sometimes it is nice to start with the temporary fillers first, just to make sure you like the look, before you commit to a more permanent procedure.

Jeffrey C. Poole, MD - Account Suspended · Answer

Fortunately over the last decade we have seen a revolution in options for the treatment of volume loss.  The best result will be gained by proper evaluation with a Board Certified Physician in a field such as Dermatology or Plastic Surgery-- and developing a plan that fits your concerns best.

	For quick correction, high safety, good correction time (6-12 months), lower up front cost and the abiltiy to "reverse" the treatment if you don't like the results-- the Juvederm and Restylane line of products are best.

	For a quick correction, a little more expense but a longer lasting correction (12-18 months), Radiesse is a great option.  I really like this product for your particular concerns.  Unlike Juvederm or Restylane, however, there is no "reversal agent".

	Probably my favorite option for you is Sculptra.  With this product we slowly "build up" to a proper correction, by stimulating your own collagen to "grow" and fill the areas of your concern.  This is the longest lasting (years), most natural correction, and long-term probably the least expensive-- but requires more initial up front cost and time to achieve the results.

	What I do NOT advocate is permanent implants.  Permanent fillers or implants can result in permanent problems.  Also, remember that with time-- facial bone and musculature change-- and that permanent result may look permanently bad!

Mitchell Schwartz, MD - Account Suspended · Answer

I use Radiesse multiple times every day to fix volume loss problems such as yours. Radiesse has given physicians and patients a new dimension in facial contouring by revolumizing the face through a minimally invasive approach. They are well-tolerated by patients, have a low incidence of side effects, and result in high patient satisfaction. Longer lasting fillers such as Radiesse have many advantages over implants. One obvious advantage is that surgery is not required. Another is that you can get either a rapid or a gradual correction depending upon how many syringes you have injected and you can decide as you go exactly how much correction looks good. Also, as your face ages it changes over the years, touch up treatments are constantly being modified to fit the changing face. Please remember, the experience and technique of your physician injector is the most critical part to your achieving a beautiful, natural result.

Kevin C. Smith, MD (retired) · Answer

Just about every day I am restoring or enhancing midface volume using Juvéderm Ultra XC®. My patients like this, and most still look good a year later compared with their baseline photos. Treatment is simple, and a major advantage of Juvéderm® [and other HA based fillers like Restylane®] is that they can be quickly and easily reversed with hyaluronidase if there is a problem or a complication.

Best Option to Fix Hollow Midface Look?

Answers (8)

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