How to improve indentations in the cheeks below the tear trough? (Photo)

Question

I’d love to find out what could be suggested for these indents in my cheeks? as well as the over all tired appearance of my under eyes? One dr over filled my under eye with vobella giving a puffy appearance(pointed out by later dr) & said nothing could be done about the cheek indents due to us having a vein in that area...? The next dr suggested Botox as the indents aren’t as visa me when not smiling..but the Botox made zero difference..

Michael P. Morrissette, DDS, FACS · Answer

Volbella is a reversible hyaluronic acid filler that can easily be reversed. I don't see evidence of overfilling in your photo. There are multiple treatment options for your situation. Tear trough filler is usually placed deep along the bone to provide improved contour to this area. HA fillers can be used as well as your own fat as a filler. A more permanent solution might be a silicone cheek implant which can extend to the tear trough area. Good luck

Michael A. Zadeh, MD, FACS · Answer

These lines or indentations in the cheek area can be difficult to fully get rid of, but they can be improved. Often a combination of different fillers placed strategically in different layers of the tear trough and cheek area is need for optimal improvement. Sculptra to the cheeks, and lasers can be used to further improve things longer term. Make sure you see an experienced physician provider for an in-person consultation and evaluation. Best wishes.

Jason Emer, MD · Answer

A combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

Mehryar (Ray) Taban, MD, FACS · Answer

One option to consider is to dissolve the filler you have now and then use your own under eye fat bags to fill the hollow part. It's called transconjunctival lower blepharoplasty with fat bags repositioning (not fat transfer). I have performed a study and published my results on patients with your issue.

Shalini Gupta, MD · Answer

I would not recommend Botox in this area of the face and am not surprised that it was not helpful.  A filler can definitely be placed in this are either with a needle or a small cannula--with proper technique, vessels can be avoided. If the prior filler is what is causing the puffiness above the indents, I would have that removed with hyaluronidase and start over with better filler placement.  Best, Dr. Gupta

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How to improve indentations in the cheeks below the tear trough? (Photo)

Answers (8)

Answer: Lower blepharoplasty after eyelid filler injection

Answer: Lower blepharoplasty after eyelid filler injection

Answer: Cheek indentions and how to fix them

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