Advice about my best options regarding sagging in cheeks area. Any suggestions? (photos)

I am a 33 year old male. And am getting really depressed about the sagging in my cheeks and around that area I have attached some pictures for your opinion and to see if you can advise me on my best options. Also I had filler in my tear trough about 4yrs ago so i don't think the filler will be there any more but although I have always had slight blue tinting I think it's alot worse maybe tindle. Kindest regards.

Doctor Answers 7

Chin/Cheek Augmentation -- Fillers such as Radiesse, Voluma, Perlane; Fat; Implants; Sculptra

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You're going to want an expert injector.  Fat, fillers, such as Radiesse, Voluma, implants and Sculptra can all be used.  Please see a professional for an evaluation.  Best, Dr. Emer

Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 202 reviews

Advice about my best options regarding sagging in cheeks area. Any suggestions?

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 Hi, based upon the beauty principles outlined in my book on face and body beauty, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.  From the photos, your cheeks are flat anteriorly (in the front) which allows the tissues to move off of the cheeks towards the mouth.  
  • Cheek augmentation with cheek implants or a reliable "off the shelf" dermal filler can add angularity to the cheeks and mid face.  
  • 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.

Cheek volume

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From your photographs it seems that the issue is volume, not loose skin, so I would not recommend Ulthera at your age. Hyaluronic acid (HA) filler is the best choice for you - think Juvederm and Restylane families of products. We see dozens of patients weekly for cheek augmentation with HA fillers and achieve consistent results due to the extremely low side effect profile of these products and their consistent behavior in various types of patients. Regarding the possibility of Tindall effect under your eyes, it is very possibly from prior filler. We would be able to tell by evaluating the area. HA filler under the eye can persist for longer periods of time than expected. You might be a candidate for treatment with the enzyme hyaluronidase which could decrease the blue tint of the skin if due to previous HA filler.
Best to you,
Dr. Norcom

Derek Norcom, MD
Portland Physician

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Advice about my best options regarding sagging in cheeks area. Any suggestions?

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Ulthera® ultrasound laser and/or Juvederm® Voluma filler are the current gold standard treatments for lifting the cheeks in 2016.

Manjula Jegasothy, MD
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Early midface drop

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For early dropping of the face, fillers are always the first and best answer. In the tear trough, tindle effect is unlikely 4 years later but belotero and Restylane silk should not repeat that problem. 

Sculptra would be helpful.

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You have to be careful about how to improve volume in your cheeks.  I like Sculptra, which stimulates your body to make collagen.  I do not like the hyaluronic acid fillers like Juvederm or Restylane for the cheeks.  I would advise you to find a board certified plastic surgeon who has experience with Sculptra.  Good luck!

Advice for sagging cheeks

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I would recommend using a filler in your mid face which will help with the sagging you see and improve your nasolabial folds.  There are a variety of fillers that could be used, each having different advantages and disadvantages.  You could discuss the options with the physician treating you.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.