How could I plump the apples of cheeks in the long term naturally?

Faces are flat as a result of a lack of sufficient forward projection of the bones of the mid cheek. There
are 2 bones here, the outer bone is the zygoma and the inner cheek bone is the
maxilla. It is the projection of the zygoma that is the cause of the problem.
This bone doesn’t change with age, but the maxilla progressively shrinks and
this shrinkage is first apparent in your twenties. This shrinkage is the reason why flat
cheeks are not an issue in the teen years, but become so in the twenties and
significantly more so in the thirties. The muscles of the cheek and the
supporting ligaments of the cheek attach to the bone. If the cheeks do not
project there is not good support provided by the cheek bones and this leads to the early development of  laxity of the ligaments that support the soft tissues. With laxity and poor bony support  the cheek soft tissues
descend. This is what causes heaviness of the nasolabial folds.

The decision on how to treat
this is straightforward. The underedeveloped bone, the zygoma needs to be permanently
enlarged to a size that is normal and a shape that is attractive. Importantly, this is achieved using an implant that functions like bone. Soft tissue fillers and fat injections, while convenient, are just not sufficient for this structural function.Paranasal implants add fullness
to the inner cheek, maxilla. However correction of the maxilla alone is
insufficient correction for this type of cheek flatness. The zygoma also must be corrected.There are only 2 types
of material to consider for this life long correction; prefabricated porex (polyethylene)
implants or coral (hydroxyapatite) granules.

When you want natural, I would
definitely use the coral. It is purified coral from the South Pacific and
consists only of pure mineral, calcium triphosphate, the same as human bone.
Significantly the surgeon shapes the granules to the desired shape to correct
your individual situation. Then over time your own bone grows into the implant,
so effectively, you end up with your own bone as the implant. This is the only natural
implant. There is not reaction from the body or rejection.

In addition, because the cheek
soft tissues have descended, they must be elevated with a cheek lift at the
same time. It does not look correct placing an implant after the cheek tissues
have dropped.

Mid cheek lift with
hydroxyapatite augmentation is a most effective procedure and rarely needs to
be repeated. People don’t detect that you have had a cheek augmentation. All they
notice is that now you look healthy and well. Any suggestion of dullness on
your face has gone and apple like cheeks remain.You would need to look around to find an experienced plastic surgeon who performs this surgery as not many surgeons have significant experience with porex implants and fewer with coral.