Malar fat pad separation and dent: how to lift? (Photo)

Question

I've had Voluma injected to each side of my lateral zygomatic area plus PDO threads to try and lift nasolabial folds. They both helped ever so slightly but I see a separation now between upper and lower cheek where the lower part of the malar fat pad is pouched while my upper cheek is now tight. If I could push this area up (straight up and down), that would be the ideal but I don't know any procedure that would do that...do you?

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.  In a non-surgical method of improvement you can seek additional Voluma placement into the cheeks and anterior maxilla as well as infraorbicular filler placements to help smooth your cheek's transition.  If this does not help your appearance to your satisfaction surgical options would need to be considered.  Hope this helps.

Aurora DeJuliis, MD · Answer

Looking at the picture you provided it appears you need more fillers. Voluma or Radiesse would work well. Not knowing how your face looked prior to any injection or before the thread procedure it is difficult to make an assessment. Dents can appear if the threads are tight and more volume toward the nasalabial folds can be the result of fillers placed too close to the nasalabial area. But I agree you need more volume injected in the right place.

Onir Spiegel, DDS, PhD · Answer

What you regret to as a separation in the malar eminence start to appear as a result of gravity and volume loss.  Your pictures are consistent with your complaint and you'r obviously very observant. The most simple and non-invasive method to treat it would be with additional filler placement.  From the pictures you posted you probably don't need much more--another syringe or so.  You can go with more Voluma or change to another HA filler like Restylane Lyft which has a higher G' than Voluma.  Meaning,  it will hold up your skin higher than Voluma.  But, maybe it won't last quite as long.  No one filler can give you everything.  That's why I'm a huge proponent of the layering technique, which I talk about more in the video attached.  It explains this in more detail and shows how to treat this very exact issue. The good news is that from the pictures you posted you won't need much. Take care,  Dr. Onir

Anthony J. Taglienti, MD · Answer

Thank you for your question. I would suggest another 1cc syringe of Voluma to help fill in the area of transition between the upper and lower fat pads / slightly dented area. This will help not only with the contour, but will also help provide a gentle uplifting. It's quick and simple (as you well know). Best of luck!

Malar fat pad separation and dent: how to lift? (Photo)

Answers (4)

Answer: Additional Filler

Answer: Additional Filler

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Our mission is to create a world where every investment in modern beauty is Worth It.

Malar fat pad separation and dent: how to lift? (Photo)

Answers (4)

Answer: Additional Filler

Answer: Additional Filler

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Recommended reading

Everything you need to know about Voluma

Our mission is to create a world where every investment in modern beauty is Worth It.