Permanent solution to flat mid face?

Hyaluronic Dermal fillers are a good starting point as they are temporary and give you the results of a cheek enhancement with out the commitment of an implant. There are also longer lasting fillers such as Voluma, sculptura, radiesse and Bellafill that can be used to create more defined cheekbones. Fat transfer is also an excellent way to enhance the cheekbones and is permanent. I perform cheek implants in cases where there is an extreme flatness to the cheeks. I verify placement with a camera to maximally it ensure symmetry.  I suggest an in person consult with a board certified plastic surgeon who specializes in facial aesthetics to review all your options for optimal results.

Due to your young age I'd suggest a temporary (1 - 2 year duration) filler (Voluma or Restylane Lyft) to your midface.  This is a very common procedure with no/minimal recovery, no need for anesthesia, and relatively low cost.

Thank you for your pictures and questions. If you are interested in augmenting the cheek area, then fat grafting may be a good option for you. But know that facial fat grafting can be unpredictable and it is often wise to correct in a step-wise fashion with this procedure rather than risk over-grafting, especially in the face. Fat grafting can sometimes be unpredictable. Also, if you have never had any treatments to this area at all, I would encourage you to first try a deep HA filler such as Juvederm Voluma. Yes, it is temporary, but this will also allow you the opportunity to make sure you like the result before proceeding with a more permanent solution. Make sure to see a local board certified (ABPS) plastic surgeon to discuss your options.Best of luck!

would you show in your pictures can be achieved with silicone cheek implants. I've use these for more than 35 years to augment the area that you show. These come in various sizes and shapes which can be discussed and you can decide before surgery these issues. See a very experienced surgeon who can show you  natural results and not the overdone look. 

Fat grafting can definitely see of the results that you're looking for. However,  at your age I would be  somewhat concerned with performing a procedure  that is permanent and difficult to reverse  if you're decided dissatisfied with the results .  What I would first  recommend for you  is to try  a hyaluronic acid filler  first  to see if you like the results  of the volume of augmentation before settling on  fat grafting.  Voluma  would be an ideal filler and can last  upwards of two years . And if you don't like the result  you can always reverse it by injecting  an enzyme to dissolve  the filler.  If you like the results  of the voluma  and would like something more permanent  at that point  fat grafting would be your best option .

Your photo show us that you have a relatively flat cheek contour- something you inherited. Volume augmentation would be appropriate  to improve your facial proportion and contour. You have several options, and I list them from least invasive to most invasive. 
1)  Soft tissue fillers.  This is an ultra low risk, reversible, no downtime procedure. The only downside is that it will require repeat treatments over time, probably annually. This is typically our recommendation for those who've never had a cosmetic treatment. It allows you to "try on" the volume, before making a permanent decision. 
2)  Autologous fat transfer.  This would require undergoing a minimal invasive procedure that has some downtime related to swelling and minor bruising. The risks are relatively low, and the results are relatively permanent, when performed properly. 
3)  Cheek/tear trough implant.  This would require true incisional surgery, but is probably the most anatomic solution for your congenital bone deficiency.   An implant along your tear trough would, in fact, appropriately and effectively add deep volume to the location you demonstrate. 
You should seek a consultation with a surgeon familiar and experience for all these techniques to help you sort out the options. Good luck!

You look like a very good candidate for midface augmentation regardless of which technique is used.
I would opt for a subtle enhancement.
Fillers or extremely predictable and easy to work with.
Direct direct that they are temporary and may not be the best solution for a long-term treatment option.
They do give an excellent sneak preview of what a permanent solution can deliver.
Facial if I transfer is not nearly as predictable as fillers are.
Implants can give excellent results when done correctly.
One option would be to find a board-certified plastic surgeon who has ample experience with facial for transfer.
Let that Dr. work with temporary filler's until both of you feel like you've achieved the look you want.
At that point you could convert to the facial fat transfer procedure.
Hyaluronic  acid-based fillers such as Juvaderm or Restylane can be reversed by injecting an enzyme prior to fat transfer in order to not have the fillers distort what's your untreated facial contouring is.
When it comes to facial fat transfer my advice is proceed with caution.
Work with experienced board-certified plastic surgeon's who have extensive experience with this procedure.
It's very difficult to correct Bad results from facial fat transfer.
Best,
Mats Hagstrom M.D.

The projection and contour of the mid-face can be enhanced with either fat injections or implants.There are many implants available, varying in size and design. The area you're holding in the picture can be augmented with a sub-malar implant but I suggest you also consider a combined cheek implant. You have many choices to discuss with a surgeon who uses all techniques of cheek augmentation.