What’s the best treatment for malar grooves? I am 26 years old. Filler has not helped. (photos)

Question

I had tear trough filler that went very wrong the area was over filled and too superficially injected. This caused malar edema. I had the filler dissolved after 5 weeks and I am now left with two deep malar grooves going down my cheeks which I never had before. I had the filler dissolved ten months ago. What’s the best way to treat these grooves? I have had 1ml of tear trough filler and 2ml in the cheeks last month but have seen no improvement. I never had malar grooves prior to filler just hollowing.

Lucas Bryant, MD · Answer

Thanks for your question. Physical examination is really mandatory for anyone to actually give you a correct treatment plan. Without it, we are just offering generalized suggestions. I will disagree with another post regarding fat grafting to the area below the eyes. Fat grafting has several disadvantages that are not always clearly explained to patients. This doesn't mean it's not a good option in some cases, and the technology and our understanding of fat grafting is continuing to evolve.
 First, it is not completely predictable. Only a portion of the grafted fat will survive and be permanent (50-80% is common). This amount varies from patient to patient. In young patients like yourself, the fat will act like fat from where it originally came from (founder effect). So, if you have abdominal fat placed in your face, as you age it will not act the same as facial fat. This can cause a variety of issues for you many years from now, especially around menopause. Lastly, fat grafting is essentially irreversible, so if you do not appreciate your results, it cannot be reversed. This is very different from your previous experience with filler in this area.

Leonard Grossman, MD · Answer

Definitely do not have fillers placed in that area. I routinely treat this area with the use of autologous fat grafting. Fat grafting provides with natural and permanent results. Make sure you find a plastic surgeon in your area whos well-versed in such techniques. Good luck from New York City

What’s the best treatment for malar grooves? I am 26 years old. Filler has not helped. (photos)

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What’s the best treatment for malar grooves? I am 26 years old. Filler has not helped. (photos)

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Everything you need to know about Dermal Fillers

Our mission is to create a world where every investment in modern beauty is Worth It.