Best options for sunken cheeks and noticeable nasolabial folds? (photo)

nasolabial folds are tough to deal with. That’s why there are so many different treatments.  If any one treatment worked,  nobody would do the others.  The best thing for you really would be a facelift.  It won’t get rid of the nasolabial folds but will give your entire face a much more youthful appearance.  You may feel you’re nit quite ready for it and it does cost a fair amount.  So stop wasting money on other things things that are worthless like threads or fat injections and save your money for a facelift.

Thank you for your pictures. Normally, a person in their early 40's would not be seeking a surgical option for naso-labial fold concerns. You are correct in that fillers would not be a good option for you especially if you are looking for a lasting improvement.
However, I have treated many patients in your situation that have been happy with a surgical solution.  A great deals depends on the patient's skin and underlying genetic facial bony profile as well as the patient's expectations. Using fillers can improve the surface counter. But to have a significant smoother contours at the naso-labial fold region as you have experienced would require a large amount of filler that would resolve with time.
By repositioning the facial skin, in a vertical direction, your deep folds would be improved. In addition, the hollowness of your lower face region would be improved as your normal cheek fat has migrated downwards would repositioned. Putting your normal facial fat back to where came from will give you a more prominent cheek bone appearance without implants and deal with the lower facial fullness that concerns you.
Hope this helps.
Sincerely.
Michael Kulick MD

 Treatment of excess skin of nasal labial fold and cheeks etc.  mini procedures will give mini results. Cheek implants or a cheek lift combined with a facelift is what you need. Otherwise you will waste money on small procedures which do not give you what you want. Fat grafting is not a good idea in my opinion because the results are so variable. See a very experienced facelift surgeon who can discuss with you the advantages and disadvantages of many techniques. Look for excellent results. 

You do have some significant fat loss in the face which is not uncommon in people who exercise a lot as they age.  If you have some fat to harvest, that would be a good option.  Proper placement of fat will help to fill in the hollow cheeks, and elevate the upper cheek which will help to decrease the nasolabial fold.  If you have significant laxity, combining this with either a facelift of midface lift would help even more. 

 When there's a flat mid-face and flat maxilla, Cheek implants offer a permanent augmentation to that area. Cheek implants are manufactured in a large array of thicknesses, sizes, and shapes which is best determined at the time of the consultation and examination. The Nasolabial folds are best treated with temporary injectable fillers, or fascia grafts placed underneath them at the time facelift  for improvement.

I would recommend sub-malar cheek implants and a facelift to improve your facial contours. The naso-labial grooves will be improved with these procedures but this is a difficult problem that can be addressed with fat injections or soft tissue placement.