What can I do to permanently fix my saggy cheeks?

Volume and contouring of the cheeks can be created with well-placed fillers (Voluma, Radiesse, Bellafill) and Sculptra. Implants or fat are alternatives. Botox and radiofrequency can help slim and contour the jawline. Liposuction can help slim the face. Ultherapy, J Plasma and rf treatments can provide skin tightening and lift. Sometimes an early face lift or cheek implants are needed.  I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Sagging cheeks and solutions. An in person examination would be beneficial. Based on the photos a prejowl implant will make the depression below The sagging skin fill out and. Make this much improved. See a very experienced surgeon who can show you photos of his results with this implant. You can go to work the day after this procedure with only a band aid under your chin. The procedure can be done under local anesthesia.

 The photographs demonstrate a very week and recessive chin profile, therefore consider placement of a chin implant to augment the chin  forward and give width as well

Buccal fat removal combined with a chin/jowl implant would significantly improve your facial contours giving you a more defined look. Consult with a surgeon experienced in both of these procedures.

Your structure is deficient in the lower jaw which allows the cheeks to 'hang over ' the weak jawline. Your issue is common and people mistake the solutions such as buccal fat pad trimming which is incorrect. Building up your jawline (see website), will develop structure for you. Bone structure is often the key to facial contour improvement