Is cheek/midface filler sufficient or do I need implants?

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

Thank you for your question and photos. If you’re unsure about surgery, fillers are a great option to add volume to the cheek and under-eye area and create a full, supple appearance. Results from fillers can last for up to a year or more.
If you prefer more long-term results, you may want to consider cheek implants or an autologous fat transfer. Fat transfer results can last for three years or more, while cheek implants are permanent unless removed. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon or injector who can determine the best approach for you.

You seem to be a good candidate for custom cheek and chin implants. Perhaps you perceive the flatness due to the lack of volume in the mid-face region under your eyes. Fillers are a temporary solution and can be aesthetically unpredictable. As you said, your chin is a bit recessed. A tactfully designed custom chin implant should guarantee you don't encounter the typical issues associated with standard or off-the-shelf implants.
A thorough review of your particular aesthetic goals should be conducted to ensure you obtain the look you want.
Best wishes

Your images are not ideal to describe a proper approach but improvement to the lower jaw profile as well as improving the shallow 'under eye' area can be considered. Talk to the surgeon about balancing both features