31 Year Old Male, Looking for Best Treatment for Malar Crescents (photo)

With the passage of time, and at varying rates among different individuals, there can be a separation between the fat that covers the actual area overlying the cheekbone and the fat that gravitationally slips downward and inward toward the nose. At first, this separation, called the malar crease, appears more like a darkish line. With time, however, an actual triangular wedge-shaped dent may appear.

For several years already, I have achieved consistently gratifying results for treating this condition using a combination of Radiesse, a semipermanent volumizing filler, and Juvederm UltraXC to smooth and shape the middle cheek and signficantly diminishing the appearance of the line or triangular depression. The Radiesse provides for a more long-lasting result and the Juvederm permits the security of the subsequent use of hyaluronidase to diminish the correction, if deemed necessary, although the latter is seldom required when performed by an experienced injector with an artistic eye. This technique is not to be confused with a cheek augmentation, which specifically enhances the cheekbone regions.

Fillers as your doctor are an option.  This is a problem that does not have an easy solution.  Without the benefit of an exam in person, it looks to me like you have malar edema.  This is a collection of fluid under the skin based more on your individual anatomy, than anything else.  In at least 50% of cases, I have been able to resolve this using a tiny, micro liposuction cannula to both remove tissue, as well as to create scar tissue beneath the skin. 

Post-operatively, I place a small cotton dental roll, or a small piece of rolled up gauze, taped over the area for 24 to 48 hours.  The results are variable, no has gotten worse, and at least 50% of the people have complete resolution.

Cheeks can be augmented in men and women safely with fillers. Judging by your picture, you would be a good candidate. Make sure you go to a doctor who is experienced in doing the procedure in both, men and women.

These malar cresents are best treated with a filler. I personally use Juvederm but others use Radiesse with excellent results.

I agree with your physician and would recommend the injection of Radiesse in these grooves. I cannot see the complete contour of your cheeks with this picture, but you can also consider a limited lateral cheek lift or a silicone implant .

A soft tissue filler, like Perlane, would be my first choice to fill in that area as well as augment the cheeks.  If you wanted something a bit more permanent with more augmentation, you could consider silastic Cheek Implants.

I agree with your doctor that Radiesse is the best filler/treatment for this area. Radiesse is injected deeper, beneath the skin, and will generate more volume to create a much better lifting effect and therefore a better, longer lasting result than the other fillers. Since Radiesse is not reversible, it is especially important to remember that the experience and technique of the physician injecting Radiesse is the most critical part to your achieving a beautiful, natural result. I have been injecting Radiesse for over 8 years and have never had a problem using it in a first time patient.

Injecting a filler in to this area will definitely help smooth it out. While I agree that Radiesse would be a good choice, I usually don't like to do Radiesse on first time filler patients. I prefer to start with Restylane or Juvederm so that the patient and I both know that if they really don't like how fillers work or look, the product can be taken out with hyaluronidase to allow the patient to return to their baseline. There is no product available to counter Radiesse so if patients don't like it, they just have to wait for it to disappear on its own, which can be upwards of a year.