What are your suggestions for a flat midface? (Photos)

I wholeheartedly agree with your concerns about fat injections. The results are unpredictable and not permanent. Moreover, any fat that does remain retains the characteristics of the location (stomach, buttocks, thighs) from which it was taken--meaning that in mid-life when fat from those areas begins to bulge, it can do so in the face where it was transplanted. I take exception with the idea that implants are permanent. The implant itself IS permanent. However, the tissue around it will age, so that what may look fine right now, in five years or ten, when the tissues around age, the implant may no longer be satisfactory and may need to be removed and surgically replaced with a one that better fits the age-related changes. Injectable, natural volumizing and lifting fillers provide a natural looking and safe solution to facial contouring and shaping and are easily injected over time to fit the ever changing and evolving nature of our faces. Just make sure that you consult with a board certified aesthetic physician with experience and expertise and avoid cut-rate medspa, non-physician venues. Hope this helps and best of luck.

Facial sculpting and contouring can be created with well-placed fillers (Voluma, Countour, Radiesse, Bellafill) and Sculptra, which would give improvement in facial balance. Fat or implants are alternatives. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Hi, for your face I recommend you fillers. Fillers to cheek bones balance your face. If needed further consultations you can have more fillers to needed areas.

I absolutely love adding filler (I use Voluma) to the mid face/cheekbones. This gives and instant lift while adding some volume to the apple of the cheeks.I think filler would be a great way to "test" if you would like a more permanent solution so you can see what you potentially could look like without it being permanent. Filler can also be dissolved if needed. I have have VERY few instances of filler migrating.

Thank you for your question. Personally, I would not recommend fat transfer or permanent implants as there are dangerous side effects with them. Fillers would be the safest way to go and although it is not permanent you may have some collagen left behind in their place as you keep up with it. I would suggest using Voluma and starting with maybe 2 or 3 syringes. Hope this helps!

You’ve not stated your age, but I can see your concerns clearly and agree- the area that needs the most help is the midface- specifically, your cheeks and under-eye area are beginning to lose volume, giving you a flattening of the Ogee curve.
The ageing process means (in my opinion) that a relatively mobile area such as the midface, permanent solutions aren’t ideal as this process will continue your whole life and implants etc are a relative no-no for future semi permanent fillers due to infection risk.
Similarly fat grafting is not without risk.
As much as patients like the idea of a “one and done” solution, the fact is that our faces are constantly changing and ageing and need regular upkeep more than other areas of our bodies amenable to more permanent solutions such as breasts implants, tummy tucks etc
Good luck finding someone who’s a good fit!

The condition you have is inherited and usually from the father’s side and I’m sure you can confirm this just by looking at your dad. In my opinion there’s absolutely nothing better than to restore volume in the cheek and lower eyelid area than with the use of your own fat. I have been using fat grafting with 100% success rate since 1993. We treat on the average six such patients every single week over the last 26 years. You can always contact our office if you have questions. I hope this helps and good luck from New York City Plastic Surgery

You have some flatness in the central malar areas over the maxillary bone. This can be treated with fillers, fat or implants. However, your major deficit is the lateral cheek, below the zygoma, an area that has no bony support. This is the main area you corrected with your pictures. There is no place there to support an implant and fillers or fat have to be placed in the superficial fat compartment to get any projection. Make sure you see an expert in this area as most injectors will not be able to achieve your desired results.