I'm interested filling tear trough & adding volume to malar area. What would you recommend? (photos)

25 year old female, good health, no previous cosmetic procedures. I'm interested in correcting my hereditary tear trough and adding volume to the upper cheeks. Long-term or permanent result preferred. Implants, fat injections, and midface lifts are procedures I've seen in my research. The midface lift could also heighten the lip commissures and expose more of my upper lip, but that isn't the priority. Take a look at my photos and see what you think is the best route for me.

Doctor Answers 14

Best Treatment for Filling Tear Trough and Adding Volume to Malar (Cheek) Area

Hi Samantha,

I would treat you with Voluma in your cheeks and Restylane under your eyes if you were my patient.  These fillers last a long time in these areas.  I am hesitant to use permanent fillers as it is said, "Permanent fillers, permanent problems!"  Even though the chances of adverse events are smaller with some of the newer "permanent fillers" and fat transfer, if there is a problem in the lower eye and cheek area it is very difficult to correct.  I would stay away from midface surgery or implants as well.  At your young age, I would stick with Voluma and Restylane, only with an expert, skilled injector with natural artistic vision.  Choose your injecting physician most carefully.  Good luck and be well.

Dr. P

Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

I'm interested filling tear trough & adding volume to malar area. What would you recommend?

Voluma is a great non-surgical option to augment the cheeks. We also see that alot of patients experience improvement in the tear trough area due to the lift of the product. This is a reasonable approach for people desiring cheek augmentation via a non-surgical approach. If your tear troughs were still too deep after Voluma, a thinner filler such as Restylane could be used to directly fill that area. I hope this information is helpful for you.

Stephen Weber MD, FACS
Denver Facial Plastic Surgeon

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Improving appearance of eye hollows

From your photos, it looks like you would do best with the hyaluronic acid filler Restylane or Perlane in the medial cheek area and in the lower eye area. The results you can get from this are long lasting and natural. I would avoid permanent filler in this area. A cheek implant is an option but really you can get such good, long-lasting results with Restylane or Perlane that I think filler would be a better option for you.

Elizabeth F. Rostan, MD
Charlotte Dermatologist
4.4 out of 5 stars 18 reviews

I'm interested filling tear trough & adding volume to malar area. What would you recommend?

Thanks for the question and great posted photos. I tell my patients to start slowly before going permanent. In other words I would first do fillers and BOTOX injections to see if you are satisfied. I would use Belotero Balance for the tear troughs (1 syringe), 2 to 4 syringes of Voluma for cheek hypoplasia, BOTOX for wrinkling. This will cost from $4,000 to $6,000. If after you see the results and you desire a more invasive treatment than surgery can be discussed. Good Luck... 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Correcting Tear Trough and lack of Malar Fullness in the Young

The best way t add fullness to the malar area which you appear to need and to improve the tear troughs is with a filler. Of the off the shelf fillers, Juvederm Voluma appears to presently be the best. However, in someone your age, I would suggest fat grafting the area. Although this may take 2 sessions 4-6 months apart to achieve your desired contour, once this is achieved, the results are essentially permanent. 

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews


Fillers can be used with a lot of success in the tear trough region and the malar region. Best of luck. 

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Facial Fillers, Am I a Candidate

You look like a great candidate for fillers, I would avoid any surgery for now.  There are many options for filler types and you should seek a formal consultation with a cosmetic dermatologist to get an opinion on what is best for you.  I wish you luck, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

I'm interested filling tear trough & adding volume to malar area.

Yes, I agree.  You do need more fullness to the cheek area.  Your face is relatively flat and needs volume.  Yes, you can start with fillers, but ultimately, you may decide on cheek implants, as these are permanent and will give your face the necessary shape.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Filling tear trough and malar area

Hi Samantha. Since you have never had any type of cosmetic procedures before I would recommend correcting these areas with a Hyaluronic Acid filler such as Juvederm, Restylane, or Belotero. My preference would be to use Juvederm Voluma for your cheeks to volumize your midface. This will also help improve your tear troughs. The tear troughs can then be treated with Belotero to help blend with the midface. Juvederm would be great to help enhance your lips. Hope this helps!

Michael A. Zadeh, MD, FACS
Sherman Oaks General Surgeon
5.0 out of 5 stars 10 reviews

Tear trough

Samanthateal, Look up the "SOOF lift blepharoplasty" and I think you will find that this procedure will address your concerns. For you cheeks starting with a temporary filler isn't a bad idea. This will allow you to try out this look before committing to implants. Always choose a facial plastic specialist for you procedure and check out their photos before you visit. Good luck!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 48 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.