What can I really do with these indentation marks on my face? (photo)

I've had these deep indents at the tops of my cheeks for a long time. I can hardly take pictures because they always show up if the lighting is not just right. I hate going into well lit areas because they become so prominent. I feel like people are always staring at them and it tears down my self confidence. I've gone to a plastic surgeon years ago and they stated that there wasn't much to be done and that they didn't even notice it until I had pointed it out. Ideas on permanently removing?

Doctor Answers 3

Malar bags

infl12, your photo is not too helpful but you may have a malar bag. These present in the 3rd to 4th de4cade as subtle swelling inferior and lateral to the lower lid. The tendency runs in families. They are due to interstitial edema and not excess fat or muscle. I have performed a "SOOF lift blepharoplasty" in patients with these conditions with good results. Fillers to mask the swelling may help. Ablative resurfacing can be beneficial. See 2-3 facial plastic specialists and get their opinion. Hope this helps!

Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 48 reviews

Malar Creases

Better photos are needed but the indentations to which you refer appear to be creases caused by malar bags. These are difficult facial problems to treat as it is really chronic swelling/lymphedema of the tissues. Direct under the skin cauterization through a lower eyelid approach to shrink the swelling and very small cheek implants or fat injections underneath may be helpful.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

What can I really do with these indentation marks on my face?

You have something called malar bags.   You can not completely resolve this issue, as it chronic swelling with a build up of connective tissue within the bag.  You can address a bit, but I would need to see a full view of your face: front and side view; not smiling.  The options could be filler to fill in the indentation; possibly a bit of microliposuction below the bags to reduce that difference; possibly cheek implants...but without complete photos, it is hard to say.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

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