Large cheekbones and hollowed out cheeks - Should I get a fat transfer? (Photo)

Question

I’m 27 and I hate the shape of my face. My cheekbones are huge and I’m so hollowed out I keep thinking I should go to Korea and get them shaved down or something but I just don’t feel pretty or feminine. I’m embarrassed looking other people in the face because I’m worried about them looking at my cheeks.

Randal Haworth, MD, FACS · Answer

What you describe sounds less like a simple volume deficit and more like a shape problem: strong zygomatic bones with relative hollowing in the cheek body beneath them. Fat transfer can soften a hollow transition, but it will not reduce a large cheekbone, and overfilling to hide bone often looks puffy rather than feminine. Bone contouring is a different operation with different trade-offs. The first question in person is which layer is actually bothering youâbone width, soft-tissue hollow, or bothâand whether grafting, an implant strategy, or neither is the honest tool. Photos alone cannot settle that. See a board-certified surgeon who regularly separates skeletal from soft-tissue midface plans.

Tim Neavin, MD · Answer

First, thank you for sharing your concerns so openly. I want to offer you a different perspective because, from what you're describing, the very features you're considering surgically reducing may actually be some of your greatest aesthetic assets.

You have a fantastic architectural starting point for facial rejuvenation and balancing. Prominent cheekbones are often an extremely desirable feature. The issue isn't necessarily that your cheekbones are too large, but rather that the surrounding areas lack sufficient volume to create a harmonious transition between your facial contours.

This is an important distinction, particularly at 27. Before considering something as permanent and invasive as zygomatic bone reduction, I would strongly encourage you to explore what can be achieved through conservative, strategically placed facial fat transfer. Feel free to email me and I can share a very similar scenario; how I did not reduce cheekbones and instead, added fat to the entire face.

Facial beauty is not simply about the size or projection of individual features. It's about the relationships between them. When the temples, submalar region, and lateral cheeks are relatively hollow, the zygomatic arches can appear disproportionately prominent. By restoring volume to these surrounding areas, we can soften that contrast and create a more balanced, feminine facial contour without altering your underlying skeletal structure.

In the right candidate, relatively subtle changes in precisely selected areas can produce a significant improvement in overall facial harmony. The objective would not be to make your face round or excessively full. It would be to preserve your beautiful cheekbone architecture while softening the transitions that currently make those cheekbones appear more pronounced.

I would also emphasize that facial fat transfer is an exceptionally technique-sensitive procedure. The quality of the result depends on much more than the amount of fat transferred. I approach it as a series of interdependent decisions, beginning with a detailed assessment of facial anatomy and proportions.

Instrument selection, fat harvesting technique, suction pressure, processing methods, and preservation of the harvested tissue all deserve careful consideration. Equally important are the anatomical depth, quantity, and distribution of the fat. Small, strategically placed deposits can reshape the relationship between adjacent facial regions without creating an augmented appearance.

I also place considerable emphasis on preoperative and postoperative nutritional protocols to support healing and provide favorable conditions for graft survival. Even with meticulous technique, some fat resorption is expected, but the surviving graft can provide long-lasting, potentially permanent volume.

One of the most important lessons from years of performing facial fat transfer is that adding volume in the correct location can sometimes make a prominent feature appear less prominent. This may sound counterintuitive, but it is fundamental to facial balancing. We are changing the visual relationship between features rather than simply making everything larger.

I would be exceptionally cautious about undergoing zygomatic reduction without first obtaining a thorough evaluation. Bone reduction permanently changes the facial skeleton and introduces considerations involving soft-tissue support, facial width, contour irregularities, and potential nerve injury. It is not something I would rush into when a less invasive approach may address the concern.

I genuinely believe the facial characteristics you've described could lend themselves beautifully to subtle but meaningful facial balancing with fat transfer. I would want to examine your photographs and ideally evaluate you in person before recommending specific treatment areas, but I certainly wouldn't assume that your bone structure needs to be changed.

The goal would never be to give you someone else's face. It would be to preserve what makes your facial structure distinctive while creating softer, more harmonious transitions so that your features work together naturally.

Mark Beaty, MD · Answer

I'm sorry to hear how much this has been affecting your confidence. Based on what you've shared, I would strongly advise against undergoing surgery to shave down your cheekbones, as that is a major procedure with significant risks and may not address the underlying concern. Instead, if your primary issue is facial hollowing, I would first consider a non-surgical approach with hyaluronic acid filler or Sculptra to restore volume and soften the contours of your face. If you find that adding volume gives you the look you're hoping for, then fat transfer could be a reasonable longer-term option. I generally recommend starting with a reversible or non-permanent treatment first so you can evaluate the results before considering anything more permanent. Best of luck to you.

Lexie Wang, MD · Answer

Of course, ironically this is literally the face that some people get surgery such as buccal fat removal or pay for filler to achieve. So you should know that the grass is always greener on the other side. That being said, fat grafting would be great to help soften everything to make you feel more "pretty/feminine".

Zoran Potparic, MD · Answer

It is very difficult to make good assessment of your face and cheek bones in particular based on this photo. A series of photos with full face and profiles would help. Person consultation with. Board certified plastic surgeon with experience in facial contouring would help. Good luck.

Dallas Buchanan, MD · Answer

Sorry to hear about your struggles. However, all I can tell you is that you look completely normal. There are people out there who would kill for cheekbones like that. In fact, there are millions of people out there who get filler yearly with a goal to achieve a structure like you have naturally. Whatever you do, do not "go to Korea and get them shaved down or something..." I assure you that with time you will regret any such drastic steps to alter your facial appearance at this young of an age. The fact that you are worried about everyone looking at your cheeks is more a symptom of what is going on in your head than what is actually occurring in reality. Love yourself the way you are and stop worrying about what other people see or think! All the best,
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

Large cheekbones and hollowed out cheeks - Should I get a fat transfer? (Photo)

Answers (6)

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