I'm 33 years old, female, my cheeks have started to sag. Recommendations for mid face sagging? (photos)

Question

Hi, i am 33 year old female have been noticing my cheeks have started to sag giving the appearance of prominent nasolabial folds and lines under my eyes that go down upto my cheeks. I always had heavy cheeks and the sagging has worsened it. Please suggest what treatment would work best. For fillers how much units would be recommended, i recently met a dermat and was told i may need 7+ syringes which i think is a bit too much... thanks!

Jason Emer, MD · Answer

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

Jonathan Kulbersh, MD · Answer

I believe fillers might be a good start for you in addressing these early signs of aging. Another option, which you could combine with fillers, is a skin rejuvenation procedure like RF microneedling or laser resurfacing. These procedures boost collagen levels in the dermal structure to firm and refresh the skin for a more youthful complexion. I encourage you to schedule a consultation with a board-certified facial plastic surgeon who can assess you in person and create a customized treatment plan to meet your needs and goals beautifully.

Pavan Murdeshwar, MCh · Answer

Hello, thank you for the pictures. That helps in noticing the highly prominent nasojugal line and naso labial groove. Some kind of fillers will definitely help you get back the youthfulness. That can be fat filling (where fat from other parts are used, for long lasting effect) or by artificial fillers (that will last for 2 years max). You can choose either of those yourself or take an opinion from a certified plastic surgeon for the same. 7+ fillers is too much for the start.

Teresa Camden, MD · Answer

I would certainly recommend adding volume in your cheek and undereye area with filler. I like to build volume slowly with my patients to avoid an overfilled or unnatural look. I would suggest starting with 1-2 syringes and then building from there to achieve the look you desire.

Matt Tahsini, MD · Answer

Hello and thank you for your questions. Fillers are a good option for you however I don’t think you need 7 syringes. I suggest you see a reputable doctor and discuss your wants and plan what is best for you. Best wishes.Dr. T

Gregory Chambon, MD · Answer

If you look under your eyes and the upper lateral cheeks you will see a hollowness from loss of volume. You would greatly benefit from having these areas filled with a cheek filler such as Juvederm Voulma. Secondarily, this will lift your lower cheeks and improve you nasolabial folds.

Richard Ort, MD · Answer

I would start with filler to the upper face- the mid-cheek groove extending to the tear trough. You could start with 2 syringes. You don’t need 7 syringes at age 33! Filler in upper face is best injected with a cannula to minimize bruising, risk, or downtime. Regards,Dr. Ort

Camille Cash, MD · Answer

You have several options to improve your concerns.  Fillers can be used to lessen the depths of the nasolabial folds.  You can consider Silhouette InstaLift which is a non surgical lift for the mid face with minimal swelling and down time.  Another option is FaceTite which improves sagging and tightens skin.  Results are optimized by adding Morpheus 8 treatments.  These options are also non surgical.

Sonam Yadav, MBBS, MSc - Account Suspended · Answer

I would suggest a combination approach that addresses the skin laxity first with energy based devices then address the remaining concerns with dermal filler in the mid face region (using 1-3 syringes)

Rita Rakus, MBBS - Account Suspended · Answer

Hello and thanks for your question. It's always hard on photos alone but based on your photos you have provided as an starting off treatment we could go for 1ml each side and 1ml split to the facial folds Always go to a qualified and experienced practitioner for any injectable treatment, best wishes

I'm 33 years old, female, my cheeks have started to sag. Recommendations for mid face sagging? (photos)

Answers (10)

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