I have genetic deep mid cheek grooves and saggy cheeks at 22, what can I do to improve them? (photos)

I encourage you to begin by visiting with a board certified plastic surgeon near you for a consultation. Depending on the nature of the tissue some options may include FaceTite, Morpheus8, or potentially Evoke Facial Remodeling. Visit my website or a provider near you to learn more.

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

A combination approach would give the most improvement. Deep wrinkles and smile lines can be improved with a combination of Botox and/or fillers for the lines themselves and to build anatomical support with Sculptra for collagen building. Ultherapy is a great skin tightening device, but works best in combination with other treatments like J Plasma, RF treatments, lasers, microneedling/PRP, salt facials, Cosmelan for skin tightening and improve skin tone. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

The support of the soft tissues of the face come from the maxilla, the jaws and the teeth. I suspect that your would be an excellent candidate for a DNA Appliance and Epigenetic orthopedics.

Correction of hard tissues allows soft tissues to follow the contours.

1. Filler that got dissolved:
If you had filler and got it dissolved, it is very important that you got all of that filler dissolved completely. If you had already had more than one session (of dissolving) it may be prudent to get an MRI to determine if any of the filler is still present or if there is another concern.

2. Not a great candidate for surgery:
Are you "not a great candidate for surgery" due to an underlying medical condition? If you are "not a great candidate for surgery" due to reasons that could be treated; please begin to make those changes for the betterment of your health and quality of life; I'm recommending that you make those changes because surgery would be the only option that would completely remedy the "malar festoons" that you've developed.

3. Options:
Non-invasive options: Getting treated with a Radio Frequency Assisted Laser (RFAL) would improve the lines to a certain degree. I would recommend fillers, but considering your recent dissolving, it seems best avoided. I recommend (if you're not already) to begin using sunscreen in the morning (or before you go-out) and avoid substances that age you such as smoking, drinking, and sugars (fruit and natural sugars are fine to a certain extent) as much as possible. It's essential that you begin checking ingredients when shopping for sunscreens and for your food/beverages. Sadly due to lack of regulation in America (unlike other countries) we have many aging, disease causing, toxins and hazardous chemicals and "ingredients" in our food, household products, on our clothes, and nearly every other product. Please research and make the best choices for your own health.

This can be treated with either a filler or a PDO thread lift. Before going for the thread lift I would opt for the filler as it could be an easier and quicker option. Otherwise a PDO thread lift may be a good treatment for you.