I have protruding lower cheeks and hollow mid face. What treatment would you recommend? (photos)

Question

I have protruding lower cheeks and hollow midface, would it be possible to rebalance face as roughly shown in those pics? I'm 27 years old, height 181cm, weight 60kg.

Toby Mayer, MD · Answer

Your face is good looking and you should leave it alone. All surgery carries risks and the chance of making a good looking face worse is not worth it.

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Jed H. Horowitz, MD, FACS · Answer

Hello stevenmayA facelift is a surgical procedure designed to remove the major folds and wrinkles that form on our faces with age. Gravity, sun damage, smoking, living in a dry climate, and a variety of factors contribute to the aging process of our faces. Facelift techniques vary from patient to patient to give each person a procedure tailored to produce the best possible surgical result.
A facelift will:
smooth out major folds and wrinkles,tighten the tissues beneath your skin,remove sagging and excess skin.A facelift can also reduce excess skin around the neck and jawline.

Mehryar (Ray) Taban, MD, FACS · Answer

You may benefit conservative filler injection to achieve fuller cheeks. It has to be done so the results are natural appearing.

Laxmeesh Mike Nayak, MD · Answer

You look great already, but your goals can be achieved with injectable fillers like Voluma, Radiesse, or Perlane to emphasize and lift the upper cheek.

Stephen M. Davis, MD, FACS · Answer

I agree with Dr. Mayer, your face looks great. Don't mess it up or start changing things. You may not get what you asked for. When people, especially very young people get on the Merry Go Round of fillers etc,  it's hard to get off and then you are really unhappy. Filler are designed to re-volumize the face, your proportions are excellent.Stephen M. Davis, MD, FACSGreen Hills Plastic Surgery

Steven M. Daines, MD, FACS · Answer

In general, there are three options for augmenting the cheeks. A mid face lift is a surgical procedure that lifts fallen cheeks to a more youthful position. Cheek implants can be placed surgically to enhance mid facial shape and contour.A laundry list of fillers (Radiesse, Sculptra, Voluma, autologous fat, etc) are available to add volume to the mid face.Each of these alternatives has pros and cons. The cheek enhancement strategy you select must be tailored to your unique anatomy. The only way to make such a determination is through an in-person consultation.

Darryl J. Blinski, MD · Answer

I recommend 2 to 4 cc's of Juvederm's Voluma injections to alleviate your issues.. Fee from r$3,500 range...

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed many facial shaping procedures using dermal fillers, silastic facial implants (silastic cheek implants, silastic chin implants), liposuction and/or facelifts for over 30 years.  Following my beauty principles, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.  From the photos, your cheeks are a tiny bit flat in the front however, the chin is very weak.    The following procedures would create a more ruggedly handsome face.
Cheek augmentation with  a dermal filler to add angularity to the cheeks and mid face.  
Chin augmentation, using a silastic chin implant, to add projection to the chin creating harmony and balance to the lower face.  I have performed many facial shaping procedures, including Chin Augmentation with dermal fillers or silastic chin implants, for over 30 years.  When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy, the lower face looks short, de-emphasizes the lips and allows early formation of a "double chin".  Proper placement of a silastic chin implant adds forward projection to the chin thereby creating harmony and balance to the lower face.  Using the same incision, liposuction can be performed to reduce the fat and further shape the neck.  Excess skin, from below the chin, can also be removed through the same incision.  I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty (requires extensive tissue dissection, bone cuts and placement of metal screws and plates to secure the cut bone segments).  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.  
Augmentation of the mandibular angles using a dermal filler (jaw implants have too many unwanted side effects IMHO) to add volume, angularity and flare to the jaw line.
Hope this helps.

I have protruding lower cheeks and hollow mid face. What treatment would you recommend? (photos)

Answers (9)

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