Cheek volume loss - what procedures would be best to permanently masculinize my face? (Photos)

Question

I have lost a significant amount of volume in the mid face region and currently have it replaced with hyaluronic acid 2x per year to reduce nasolabial folds/marionette lines and to prevent sagging at the corners of my mouth. I am interested in a combination of permanent procedures to masculinize my face. I was thinking chin and jaw implants plus rhinoplasty, and possibly cheek implants? I just feel that my face appears very wide and there aren’t a lot of traditionally masculine features.

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. You may benefit from facial implants to create the sculpted, masculine appearance you’re looking for. Cheek implants can increase the fullness and definition of the midface, while chin implants can define the jawline and create a striking contour. In both instances, silicone implants are an ideal choice as they’re easy to customize and shape and can be easily removed at a later date, should that be desired. Facial implants provide the longest-lasting solution to the areas of concern you refer to. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon. They will be able to review your injection history, discuss your aesthetic goals with you, and help you decide on the best course of action.

Jason Emer, MD · Answer

Facial sculpting and contouring can be created with well-placed fillers (Voluma, Countour, Radiesse, Bellafill) and Sculptra, which would give improvement in facial balance. Fat or implants are alternatives. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Alejo Villarreal, DDS · Answer

Hi David,
I can see that the volume in your mid-face area is a bit "flat," and that causes your eyes to look a bit "tired" and older. As we age, we lose fat and muscle volume, especially under the eyes and zygomatic bone region, which causes disharmony to the face overall. 
The best and only permanent solution for adding volume, shape, and controlled harmony to the mid-face is by using custom-fit and, more importantly, custom-designed implants. The marionette lines naturally dissipate a bit when the implants push the skin up. The implants plump up the surrounding areas a bit, thus giving you a natural look. 
In my personal opinion, your jaw angle seems a bit high and narrow. However, we can only be certain when you invest time working with my team in designing the exact look that works for you and, more importantly, the look you want.
The jaw angle implants will give you a more "masculine" look and fix any asymmetries in your jawbone. The chin implant complements the other two areas - special care must be implemented to ensure you continue to look like a better version of yourself and not like a completely different person ( unless, of course, that is what you want). 
Best of luck.

Gerald Wittenberg, MSc, DMD (retired) · Answer

Your overall view is reasonable. You could benefit with jawline augmentation to strengthen the lower facial contours and also cheek implants placed appropriately to a male face; to balance the now stronger jawline. Common procedures performed from inside the mouth.

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