What treatment do I need for volume loss under eyes and sagging cheeks?

Thanks for your question, Shelly. It’s hard to assess your concerns without photos or a physical exam, but Voluma is a great dermal filler that can be placed in the upper/lateral cheeks to help restore volume loss, lift the mid-face and reduce some hollowing of the eye. Additionally, Volbella can be used to fill the tear trough/under eyes as well as the upper orbits depending on the degree of volume loss or hollowing. For pigment and texture issues, I recommend regular use of topical products like Retin-A and Vitamin C as well as BBL or Halo laser treatment to manage pigments and textures respectively depending on your needs. Regardless of your treatment choice, I always advise judicious use of sunscreen on a daily basis to help prevent future damage and protect post treatment results. Good luck!

You are experiencing the early signs of aging that many of my patients are also experiencing. Today there are so many incredible non-surgical treatments to instantly improve your appearance. To address lost cheek volume, I usually recommend Voluma injections. Voluma is a great filler that lasts up to 2 years. We can combine the Voluma injections with Restylane under the eyes to get rid of the hollowing that is bothering you. Finally, to improve your skin tone and texture, a series of chemical peels and a good skin care routine should help significantly. However, I would need to evaluate you in person to confirm that all of these treatment options are right for you. Please make sure you consult with a board certified plastic surgeon or dermatologist to ensure you get the best recommendation and treatment possible. 

The most common treatment for significant volume loss in the cheeks and the area just under the eyelids is the use of injectable fillers. Fillers can be synthetic or they can be natural-that is it can be with your own fat. We call that a fat transfer. Synthetic fillers are usually hyaluronic gel's such as Voluma, Restylane or Juvederm. Voluma is best in the outer cheek area, Juvederm and Restylane finesse the more medial or insight cheek a bit better than Voluma I find. Your plastic surgeon at your consultation will discuss with you the pros and cons of each agent.

Complexion is improved with skin care , lasers and microneedling.  Fillers improve volume, hollows and fine lines.  Please see an expert for treatment.  Best, Dr. Emer.

Thank you for your question. Voluma is a great option to address the volume loss on your cheeks.  I prefer a less viscous filler such as Belotero for the tear trough/ periorbital area.  For skin pigmentation and texture problems, there is a vast array of treatment options (laser/ IPL/radiofrequency/ micro-needling/ dermabrasion etc) that are available and a in-person consultation with a board certified plastic surgeon/ dermatologist is warranted for more specific recommendations.  Best wishes.  

You describe the loss or descent of volume from your upper cheek, leaving a hollowed appearance below the eyes. This is a common sequence in early facial aging and can be addressed very simply with the use of HA fillers like Juvederm in the upper malar and tear-trough zones. The injection plane for this particular application is deep - along the facial bones. Seek out an experienced injector with hundreds of facial filler injections in the past year for best results.

 This is a fantastic question that comes up every day in consultation.  Volume loss in the mid face can be one of our first signs of aging, and  people very commonly seek correction of this issue.  The great news is, there are multiple new volumizers/fillers on the market with excellent duration, safety profiles, and reversibility that have dramatically changed the way we can correct this midface volume loss.  Old techniques involved surgical implants into the midface, but these are often not necessary anymore, especially with younger patients who need minimal and focal correction. with all of these new, excellent options on the market, it becomes very important to choose your injector wisely. Not all injectors are created equal, and not all have the same capabilities with this toolbox of products that we have available. To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties.

I love Voluma for volume replacement under the eyes.  It also helps the under eye area as well.  I also like Restylane for injecting the delicate under eye area.  Fraxel is my "go to" laser for reducing the pigmentation and fixing textural issues.  Please consult a board certified dermatologist with experience in cosmetic injections and lasers for the best results.  Best, Dr. Green

Thank you for your question.  An in person consultation with a well trained cosmetic dermatologist of plastic surgeon is always needed to tailor your treatment approach.  However, you do sound like you might be a candidate for one of the volume enhancing injectable facial fillers like Juvederm Voluma.  The physician injector should be experienced as deeply placed mid-face injections can pose some risks of complications. Pigmentation and texture issues can be improved, in many cases, with laser resurfacing procedures.  Again, every patient's exact situation requires a tailored approach best discussed in a face to face consult. Best of luck to you!

There are a number of good options to treat volume loss under the eyes and sagging cheeks.  These options can include injectable fillers, such as Voluma, Juvederm, or Restylane; topical skin resurfacing, such as chemical peels, or surgical treatments, such as eyelid surgery (blepharoplasty) and/or mid face lift.  Seek out a board certified plastic surgeon, who has extensive experience in facial rejuvenation.  Best wishes, Dr. Lepore.