Sunken Cheeks but high and defined cheekbones. Any suggestions?

My cheeks are hollow but I have very high and defined cheekbones. It seems there is little support now beside my face and I have a couple of folds right where I smile. I don't think 'voluma' is necessary since the cheekbones are so prominent. Kind of nervous about anything that is permanent. Suggestions?

Doctor Answers 4

Mid Face Rejuvenation Works Well For Filling Sunken Cheeks

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Photos would have been very helpful. I cerainly understand your concerns. However, just to clarify, treating sunken cheeks with volumizing fillers, a nonsurgical mid-face rejuvenation (MFR), is a separate treatment from creating or enhancing the cheekbone regions with injectable volumizers (nonsurgical cheek augmentation). Smoothing sunken cheeks via MFR will not diminish the high cheekbones you currently have, since "sunken" by its very nature suggests that the area should be more elevated in the first place, which it undoubtedly was in the past. So a mid-face rejuvenation properly performed would simply be restoring the smoothness of the mid-face that you possessed previously and not elevating the mid-face to such an extent that it would detract from the high cheekbones that you currently still enjoy. I agree with your hesitancy to use anything permanent. Permanent fillers risk permanent disfigurement, if you don't like the results, and also risks even permanent complications, either immediately or even starting years later. So, I do not recommend their use. However, long-lasting volumizing fillers with good lift, such as Restylane Lyft (which would be my choice in my Upper East Side Manhattan practice) and Stylage XXL (my choice in my Israel satellite facility, where a far greater number of regulatory agency approved fillers and volumizers are available). Likely as not, the crinkles that you have when you smile will also be diminished as a secondary benefit to the MFR. Make sure that you seek consultation and treatment by a board certified aesthetic physician and be certain to ask to see his/her before and after photos. Best of luck.

New York Dermatologic Surgeon
4.9 out of 5 stars 33 reviews

My cheeks are hollow but I have very high and defined cheekbones but nervous about anything permanent.

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 Hi, non smiling photos of your face from the front and side would help with the evaluation. I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years. Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.  Conversely, men look chiseled and handsome with angularity in the cheeks, chin and mandibular angles.

 Think of facial beauty as something that "must" address all layers of the face including the skeletal structure of the cheeks and chin, the overlying SMAS muscle, amount and position of subcutaneous fat and finally the degree of skin laxity. It's an "urban myth" that pulling tissues over flat cheeks and a weak chin can create a beautiful or handsome face. Similarly, dermal fillers or facial implants alone can't lift and remove excess skin from the face and neck. Natural looking beauty is created by the aesthetic vision of what tissue layers need to be adjusted by what technique and amount.

 Non surgical skin/tissue tightening has limitations of several mm's while surgical skin removal is often 2 to 3 inches.  The difference is 2-3 mm's versus 50-75 mm's (there are 24.5 m’s in an inch) with surgical removal. So, the answer is yes you can have a non surgical treatment but you have to be realistic about the results provided by non surgical techniques. 

 Dermal fillers would be a great place to start if your cheeks are flat as this alone can feminize the entire face. In order for that to occur, the dermal filler needs to be placed in the front of the cheeks which will create a full round cheek and thereby a feminine, heart shaped face. If however, the dermal filler is placed to the outside of the cheek this broadens and widens the face which is a relatively masculinizing effect and one that will "not" create a more feminine shaped face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Cheek hollows

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Filling in cheek hollows typicall require larger volumes of fillers.  Sculptra is great for this.  Also, multi-layered fat injections can lead to a more permanent result.  Please seek an opinion with a board-certified surgeon.  Best wishes.

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 18 reviews

Cheek Augmentation -- Radiesse, Fat, Restylane Lyft, Juvederm Voluma, Fat Injections, Sculptra, Bellafill Implants

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It's hard to answer without a picture. There are many options like fillers (Voluma, Radiesse, Perlane, Bellafill) to treat the cheek hollows. In order to improve your skin texture and appearance of lines, laser resurfacing will help tighten the skin in the cheek area and produce collagen.  See a facial contouring/rejuvenation specialist who uses cannulas for filler injections to limit bruising Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 207 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.