Indents on cheeks when smiling - is it swelling or filler migration overtime? (photos)

Thank you for your question and for sharing your concerns. Based on your description and the history of having cheek fillers over the past 15 years, there could be several factors contributing to the indents you’re noticing.

Filler Migration: While unlikely after such a long period without treatment, it is possible that previous filler has migrated or settled differently over time, contributing to the appearance of indents.

Volume Loss: Natural aging processes and changes in facial volume can also lead to the appearance of indents or hollows. This might not be directly related to the filler itself but rather to changes in your facial structure over time.

Swelling: If you notice that the indents fluctuate in appearance, it could be due to variations in facial swelling, which can be influenced by numerous factors, including diet, sleep, and overall health.

Muscle Movement: Since you receive Botox treatments, changes in muscle movement could also influence how your face appears when smiling, potentially accentuating certain areas.

To determine the best course of action, I recommend scheduling a consultation with a board-certified dermatologist or plastic surgeon. They can assess your facial structure and history with fillers to provide personalized advice. They might suggest additional filler to correct volume loss or other treatments to achieve your desired aesthetic outcome.

Best regards,