Best Option for Narrow, Hollow Face? Fat Graft? Fillers? Implant? (photo)

Many people tell me I'm attractive, and to some extent I feel I look okay. But my face has always been rather flat, hollow and bony. I do know I have an underbite, as an orthognathic sgn told me my mid-face was underdeveloped. Jaw surgery is not an option, so I am asking you guys: What would be my best bet to make my face look more plump, youthful, and less haggard/gaunt? I am concerned with my flat cheeks and undereye hollows mostly as well as my narrow lower face. Any suggestions? Thank you!

Doctor Answers 5

Options for narrow, hollow face

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The best option for flat cheeks and to restore a youthful look to the midthird of the face is cheek augmentation with implants.  This provides a volumetric improvement to the midface.  These implants come in multiple different sizes from small to extra large, but a small implant would be the best solution in this case.  The implants also come in different shapes, which are designed as malar or sub-malar implants.  The implants we use are manufactured by Implantech and we have had excellent success with those implants for over 20 years.  The implants give a very predictable augmentation versus fat, which is very unpredictable and fillers that tend to disappear over time.  

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Radiesse injected deep against the cheek bones will correct flat cheeks..

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1)  You are attractive, but you are not making it up.  You do have flat cheeks.  The simplest thing is too use skilfully applied fillers.  Radiesse deep is probably all you need, but this can be enhanced with Juvederm Ultra Plus superficially.  Very long lasting.

2)  Long term, a mid face lift may be a good option for you.  It really creates apple cheeks, and makes the cheeks and the lower eyelids blend more smoothly.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Facial augmentation

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Things to be done to "tweek" your look could incorporate hyaluronic acid fillers which can alst 6-12 months or using fat which can be permanent but may require a series of procedures to achieve the volume you desire.  An in office consultation would be beneficial.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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You are most definitely not gaunt and haggard looking.

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I would recommend microdroplet BOTOX, a small amount of under eye filler and a very tiny amount of lip edge treatment with Restylane.  Properly done, this will take 10 years off of your appearance.  I would recommend Allan Wulc, M.D. in Pennsylvania.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Narrow, hollow face

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I agree that you look attractive. To that extent, the smallest, more reversible enhancement with the lowest risk profile would be the best possible option. Fat injections in my opinion is not the first choice. I might consider a small cheek implant but you would need a careful consultation and facial anatomy analysis with an experience plastic surgeon as there are many style and sizes. The last thing you want to do is create an irreversible problem. I perform a type of midface lift that mimic a smail and your appearance when you smile illustrates the advantages of this procedure since it rounds out anfd fills out the cheeks naturally.

Robin T.W. Yuan, M.D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

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.