What can I do about my genetic malar creases? (Photo)

Hi and thanks for your question. Treatment of malar creases like yours is quite tricky. I agree with Dr. Steinsaper - fat transfer to this area is not a great idea. We treat the tear trough and malar area daily and have found that precise and conservative injections of hyaluronic acid filler usually work well. Because this is such a tricky area to inject, the reversibility of HA is a big advantage. The most important consideration is to choose a very experienced injector of this area. The last thing you want is over-injection under your eyes. Hope that helps!

these need lasers, Microneedling RF, surgery, fillers or fat for a combination results. there is no "cure" for this regardless of all the treatments tried.  renuvion does very well and so does Fractora in our practice. fillers can sometimes worsen.  if you have laxity you will need a face lift to help. Best, Dr. Emer.

HA filler is probably the easiest and best way to treat malar grooves. Occasionally, some swelling will persist above the groove that is filled, and this makes it look like the groove is still there. This swelling usually goes away within a month or two and the appearance is much better. The filler usually lasts at least a year and it can be reversed if you don't like it. See someone with extensive experience.Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa

So you can imagine, I am not going to recommend getting grafted fat for this area. Keep in mind if this type of treatment is offered to you that many of us gain weight as we get older. The grafted fat also gains weight. Trust me when I say that this is not a good thing when this happens. I personally think that the state of the art service for this mid cheek groove in hyaluronic acid filler. Service lasts about a year before it needs to be topped off and if there is ever an issues, the treatment can be backed out with an enzyme service. 

It's difficult to tell from the photos provided but you may find improvement with Morpheus8 treatments. They work by stimulating your body's natural collagen production. Visit with a board certified plastic surgeon near you for a consultation.

The options are a midface type lift versus some sort of graft - either fat or filler. Most of us would lean towards fillers as surgery is not a guarantee and occasionally the creases can recur. Please consult with a board certified plastic or facial plastic surgeon to evaluate you in person and help formulate a reasonable plan for you.