Can you help me with creases/indentation on my mid-cheek? (Photos)

Question

I received tear through filler almost a year ago. after the swelling went down I was left with an indentation /crease. I went back to the oculofacial plastic surgeon that originally injected me and he diluted it with hyaluronidase. It looked as though I had two pockets left where the cannula was inserted. Since then I went to my Botox injector hoping she could do something/anything to fix my face! She injected some filler directly into the creases BUT nothing helped! I'm not sure what to do at this point but I am left with creases on my mid cheek! Help!

Kian Karimi, MD, FACS · Answer

Thank you for your question and sorry to hear about your experience. Your areas of concern look to be fatty festoons that give the appearance of sagging under eyes. Additional filler can be added to the area, but must be placed artistically in order to create a seamless finish. A more permanent solution would be Morpheus8, a radiofrequency microneedling device that penetrates the skin to deliver heat to the fatty tissues. This will diminish their appearance while tightening the skin and promoting collagen. A series of treatments may be necessary to obtain the most optimal results. Going forward, I would recommend you to schedule multiple consultations with board-certified experts to discuss your concerns and create a tailored treatment plan for you.
Best of luck!

Jason Emer, MD · Answer

Facial sculpting and contouring can be created with well-placed fillers (Voluma, 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

Kamran Khoobehi, MD · Answer

Your before injection pictures would be helpful. Fillers do not last forever and should be gone after Wydaze injection. You may have some fillers left and may require more hyaluronidase. The other treatment is lower lid lift. Please see the link

Shaun Patel, MD · Answer

Based on the photos, it appears there is still some residual filler under the eyes which should be dissolved using hyaluronidase. Once the filler has been dissolved, you would need to be reevaluated by an experienced aesthetic physician for filler treatment. You may benefit from retreatment using filler to the undereye and cheeks. First, however, start by dissolving the filler that still remains as it maybe causing some swelling.

Leonard Grossman, MD · Answer

I would visit a plastic surgeon who specializes in fat grafting. One or two more treatments of hyaluronidase in very small amounts should dissolve excess hyaluronic acid. Once it's done, I would follow up with fat grafting which should produce natural and permanent results as long as it's being done by someone with a lot of experience in fat grafting. I hope this helps and good luck from New York City plastic surgery

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