What can be done with asymmetrical folds/dents in one of my cheeks? (Photo)

Question

I have this weird band/fold and dent in my right cheek when I smile, that’s much more prominent now that I’m in my mid 30s. I’ve had fat transfer to my face and it didn’t help. I don’t want to use fillers and am looking for a more permanent solution. Would facelift help or something like micro amount of fat dissolve?

Ronald J. Edelson, MD · Answer

I would try Botox in the area to paralyze the muscle that it causing the dent. It might or might not work but is worth a try

Mats Hagstrom, MD (license on probation) · Answer

It’s a little hard to make a good assessment based on the single dynamic picture. We generally make assessments of the face without facial expression. Issues related to dynamic expression are difficult to treat, and generally should be left alone. In other words, if your face is fine when you don’t smile, then the problem becomes complex and difficult to address.
It sounds like you have a dimples.
Fat transfer is not going to work effectively for dimples.
It’s not a volume related issue, but rather related to connective tissue tethering on the skin during facial expression.
I don’t think you need surgical intervention, but you can always schedule consultations with other plastic surgeons to see what they have to say. I suggest not moving forward with surgery unless somebody has a very clear assessment, including a common diagnosis and proof of affective treatment and previous patients.
Don’t sign up for experimental surgery of conditions surgeons have not treated in the past.
I have a feeling what do you need more than anything is reassurance.
I don’t think you’re going to get the answers you’re looking for by posting on this website.
Best,
Mats Hagstrom, MD

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