This mid cheek groove is related to the soft tissue of the cheek and a combination of treatments may be used to address it. Removal of the three lower orbital fat pads during lower blepharoplasty will not worsen the cheek, however it will not improve it either. The mid cheek groove is often caused by volume loss in the area from either weight loss or sagging of the cheek tissue. Replacing volume with platelet rich fibrin, fat graft, hyaluronic acid fillers, or sub-malar implants can help. In some cases, a midface lift is helpful. In mild cases, surgical grade laser (Sciton Erbium YAG) or a series of radiofrequency microneedling treatments (Morpheus) can tighten up the skin enough. Any laser or radiofrequency microneedling should be done prior to hyaluronic acid filler treatments since the energy from those treatments can partially dissolve the filler. An in-person consultation with a facial plastic surgeon will allow the best evaluation of your anatomy to guide your care (i.e. evaluation of skin and soft tissue mobility and elasticity).
