Hollow line at medial cheeks and prominent nasolabial folds. What can I do? I've tried Fat, Voluma. Cheek Implants? (Photo)

Question

I have natural nasolabial folds that are becoming more prominent as I age. I also have a line of hollowness that runs from my year trough area down my cheek making the NF folds look even worse. I know it's going to get worse since my mother has the same issues more noticeable at age 60. I've used fillers and fat at my lateral cheeks trying to lift the NFs. It hasn't quite worked. I'd also like to address the line that is getting worse down my medial cheek. Should I consider implants? What type?

Toby Mayer, MD · Answer

Best treatment for nasal labial depressions and mid cheek depressions? Cheek implants will not correct either of the problems you mentioned. They will just make your cheeks larger.These depressinons are both in the area of the skin and just below the skin. I have found that Voluma or Radiesse works best for these depressions and you should see a very experienced injector for this.

Jason Emer, MD · Answer

If the non permanent fillers have not helped I'd considering using other fillers that are more long lasting such as radiesse, bellafill, sculptra, or fat injections with PRP.  Best, Dr. Emer.

William Portuese, MD · Answer

A full set of facial photographs are required to make any determination about being a candidate for cheek implants. The reason for this is the fact that the cheeks/ maxilla and cheek implants or three-dimensional structures. Cheek implants are composed of Silastic, are manufactured in a large variety of shapes and sizes, are inserted through an  intra--oral approach under a brief general anesthetic as an outpatient surgical procedure.  For many examples and more information, please see the link and video below

David Reinstadler, MD · Answer

I think you would get the most from a combination of injections into the folds themselves to even them out, as well as some more volume in the upper lateral cheeks. It is always tough to tell from photos, so I would recommend an in-person consultation to discuss your options.Best of luck

Michele S. Green, MD · Answer

It sounds like you may need more Voluma injected with proper placement to improve this malar area.  Implants should not be necessary.  I really love Sculptra in this area as you can gradually improve this area and the results will last more than two years.  Best, Dr. Green

Francis R. Palmer, III, MD (retired) · Answer

Hi, based upon the attached photos the line through your cheeks indicates flat cheeks anteriorly (in the front) with fat that's beginning to move and sag towards the nasolabial folds.  There is also excess facial fat below the cheeks and what looks like it could be a weak chin (better profile photo would be required to confirm).  These issues make your face oval shaped.Women look the most attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round anteriorly (in the front).  Cheek augmentation with cheek implants will create full, round cheeks anteriorly thereby feminizing the entire face.  I would reduce the excess facial fat at the same time to further shape and refine the cheeks.  If the chin is weak, this makes the nose appear larger and the mid face top heavy.  Chin augmentation, with a chin implant, can add volume to the chin providing harmony and balance to the lower face.  Hope this helps.

Hollow line at medial cheeks and prominent nasolabial folds. What can I do? I've tried Fat, Voluma. Cheek Implants? (Photo)

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