Facial asymmetry and mid face volume loss - need advice (Photo)

Hi pacificblue,It appears you have lost fat on your left cheek and tear trough area.  Your right cheek looks fine, and your left tear trough is slightly showing, but nothing dramatic.I'm not sure what caused this.  Your stronger left side looks bigger and wider vertically than your right side.  Perhaps you have the same amount of fat on both sides, but since your bone structure is bigger on the left side, it was spread over a wider area and relatively thinner than your weaker side.I think lower eyelid/cheek filler would help achieve the results you are looking for.  Check out the web reference link for an example, and I have more on my Realself profile.Best,Dr. Yang P.S. If you find my answers or other doctors answers to questions are helpful, please +1 those answers to push up the better answers to the top, which helps others who read the same post, get to the more helpful answers first.P.P.S. There is a new feature on Realself, which is the "Follow" button. It is similar to the "Like" button on Facebook. If you like my response or any of the doctor responses while you research on Realself, you should "Follow" them. You will get email updates, when the doctors you follow post any new answers to questions, post new photos, or have any new reviews.

Thanks for your question and the photos.  I find that most patients have asymmetry of their bony structures and see that your right side is not only wider but vetically taller than your left.  There's not much to do about the bony asymmetry however the use of hyaluronic fillers or Radiesse can fill the hollowing on the left side in the photo as well as strengthen the bony prominences of your cheekbone and angle of your mandible on the narrower right side.  Juvederm Ultra Plus should last approximately 8-9 months, Radiesse about a year.  If you were having a procedure such as liposuction I would consider transferring fat to your face however due to the variable degree of fat survival I prefer fillers since there is a predictable and definite outcome with their use.Meet with an ABPS Bd Certified plastic surgeon or a facial plastic surgeon to discuss your options and realistic expectations.  Enjoy your results.Jon A Perlman MD FACSCertified, Am Bd of Plastic SurgeryMember, Am. Society of Aesthetic Plastic Surgeons (ASAPS)Beverly Hills, CA