Loss of volume/flat cheekbones/sclera show. Suggestions? (Photos)

A combination approach would give the most improvement. Deep wrinkles and smile lines can be improved with a combination of Botox and/or fillers for the lines themselves and to build anatomical support with Sculptra for collagen building. Ultherapy is a great skin tightening device, but works best in combination with other treatments like J Plasma, RF treatments, lasers, microneedling/PRP, salt facials, Cosmelan for skin tightening and improve skin tone. I recommend getting a formal evaluation with an expert. Best, Dr. Emer

See following website page for examples of similar patients who underwent surgery to eliminate sclera show and add fullness to upper cheek and under eye area using internal eyelid lift with soof lift +/- orbital rim implant. Skype consultation available.

Based on these (far from perfect) photos, one can suggest augmentation with cheek implants vs. a true cheek lift. Cheek lift is particularly favorable providing that you have a true scleral show (which is not visible on your photos). This is done through lower eyelid incision or in more experienced hands through an incision placed inside the lower eyelid. Cheek pad is then mobilized, pulled up and fixed to the orbital rim with combination of bone holes and sutures. This will also lift your short lower eyelid in a more functional position. Cheek augmentation (if needed) may be done in the same time with implant or fat grafts. This procedure requires a true expert and should not be performed by any plastic surgeon. Good luck.