Female, 32, with overly hollow cheeks and manly jaws - injectable filler or fractional laser, or what? (Photo)

From the photos, it appears that the hollow cheeks are really emphasizing the jawline and that the former, not the latter is the main issue. Happily, nonsurgical cheek augmentation with the use of volumizing fillers has become quite routine these days among experienced injectors. My choice for this purpose in my Upper East Side Manhattan practice would be a combination of Radiesse and Voluma XC. Results are immediate and typically last up to two years. In my Israel satellite facility, where a far greater number of regulatory agency approved fillers and volumizers are available, I would opt for a combination of Emervel Volume and Teosyal Deep. I am not much of a fan of Sculptra, since it is not a filler, so it does not give an immediate improvement, requires a series of three treatment sessions, and is relatively expensive. I am also not a fan of fat injections. This, too, is typically a multistep process, requiring one procedure to withdraw the fat from the flanks, abdomen or buttocks, and the second procedure to inject it. And despite the claims that the results are permanent, one study evaluating fat transfer for mid-face volume augmentation (your area of interest) showed that less than a third of the initial volume injected remained after 1.5 years. Seek consultation with a board certified aesthetic core physician with experience and expertise in deep support volumetry, which is the fancy way of saying a three dimensional approach to facial volumizatio using volumizing fillers n to provide proper lift, projection and light reflection for the face. Make sure to ask to see before and after photos.

Hi @beastface. Thank you for sharing your photos. I recommend mid-face and cheek fillers.

Best of luck,

Dr. Nima

This is a common complaint among young fit women.  Fortunately, there are multiple options for improvement.  The easiest treatment would be fillers such as Voluma or Sculptra (or both).  These can be injected in the clinic with little downtime. 

you have a slight negative vector in midface. and quite the hollowness in the cheek areas. someone like yourself will require a lot of filler to fill those in. Voluma is good option. if you were my patient I would consider and offer fat injections to create a foundation for your face then add Voluma if needed. in my experience that gives a better result and is rather cost effective for most patients.

Dear beastface,
It appears your midface has lost volume. Midface can be sunken from bone and soft tissue depletion, and that accounts for your sagginess. From your picture, you have lost volume in the anterior medial cheek, the submalar and parotid area.
Your options include hyaluronic acid filler, collagen stimulators and fat grafting. 
Hyaluronic acid fillers have the strongest evidence for safety and efficacy, with several level 1 evidence studies conducted. Of which, Voluma is FDA approved for the midface, with longevity of 18 months on average. 
Collagen stimulators, for example radiesse, sculptra take time to achieve peak results and possess mainly level 2 evidence to support its use. 
Fat grating is a surgical measure, but is operator dependent. 
For a straightforward treatment, I would suggest hyaluronic acid fillers. Filling up the abovementioned areas of volume deficit will help feminize your features and solve your gaunt and bony look.