Is there away to reduce upper cheek fat to get rid of hollowness below eyes? (Photos)

Question

When I smile, my upper cheeks push up into my eyes and create a hollowness below them. When I am straight faced this doesn't happen. Would fillers or Botox be able to stop this from happening?

Kenneth Hughes, MD · Answer

Hello, thank you for your question. It appear that you may benefit from fillers, I recommend you to schedule an appointment with a highly trained and experienced certified plastic surgeon.

Jason Emer, MD · Answer

Thank you for your question!
Yes you can do liposuction to remove some of the cheek fat however there is high risk of damaging nerves and blood vessels in the area. Plus, there is a number of people who look larger now but later lose the volume and want it back. So my suggestion is to keep the volume now and I strongly suggest that you go to a facial contouring expert to evaluate you and possibly help sculpt your face with non-invasive/non-surgical methods to help you achieve your goals.  
Best, 
Dr. Emer.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  You will never be able to eliminate these but careful placement of Botox and hyaluronic acid based dermal filler should offer improvement.

Nelson Lee Novick, MD · Answer

Although photos are seldom a substitute for a close-up, in person examination that additionally permits palpation and manipulation of the tissue, at least from what I can see in In the non-smiling photo, there appears to be volume deficit in the cheeks and a sense of elongation of the face. If this is indeed so, then the use of a hyaluronic acid-based volumizing filler to augment the cheeks would not only contribute to a more ideal and youthful heart-shaped face in repose, but would likely secondarily contribute to a more smooth transition between upper cheek and under eye even when smiling. The procedure should take no more than ten minutes tops to perform in experienced hands, and the result typically engender an immediate "Wow!" reaction.  My choice for this in my NY office would be Voluma XC and in my Israel satellite facility (where a far greater number of regulatory agency approved injectable volumizing fillers are available) Stylage XXL. Make sure that you consult with a board certified aesthetic physician and ask to see his/her personal before and after photos before agreeing to proceed. Best of luck.

Dean P. Kane, MD, FACS · Answer

Dear begin345,
Thanks for sharing your photos. 
  
Let’s start with a bit of anatomy (see link) to understand why removal of cheek fat will make your hollowness and facial appearance worse. The eyelid compartments and cheek compartments are separated and tethered to the lower orbital bony ridge. The cheek fat compartments, are similarly tethered to the lower cheek bone. If you fill the compartments with fat, the facial appearance is taught like a well air-filled sail. If you lose weight or remove fat, the sail will sag and ripple-wrinkle.
Skillful layering of filler and fat will assist in softening and sometimes visually negating a crease or fold.
  
Stimulating collagen formation and shortening of the various compartments walls will firm or tighten them to make these pockets perky and tighter… similar to the muscles in your cheeks during your smile photo.
  
As we age, we lose the ability to restore collagen loss, fat loss and the downward sagging of our facial fat pockets.
  
Rejuvenation is maintained by:
  
Replacement of fat (or filler volume) to “balloon-out” the pocket and / or
  Stimulating collagen restoration to firm or tighten the fibrous compartment walls and overlying skin. 
  In your more youthful face, adding volume is the way to go. I hope this helps. All the best!

Shaun Patel, MD · Answer

Careful injection of Botox/Dysport and HA based filler will improve these lines however not completely eliminate them.

Matt Tahsini, MD · Answer

Hello and thank you for your question. I suggest getting a filler below your eyes to increase volume thereby making your eyes look less hollow. Make an appointment with an experienced person in injectables. Best wishes.Dr. T

Leslie Pickens, MD · Answer

I agree that strategically placed Botox type products and filler with or without PRP (platelet rich plasma) will give you restoration of the appearance you seek.  There are various products that can be used to replace volume loss.  Since this is a tricky area seek an injector with experience.

Tarsys Loayza, DDS, MSc · Answer

It is necessary to determine if the need is for hyaluronic acid or botox to resort to the most correct procedure.

Camille Cash, MD · Answer

From your photos it appears a conservative amount of filler may help improve the hollowness.  The treatment is done in the office and the results last up to one year.  See an experienced injector near you for a consultation.

Is there away to reduce upper cheek fat to get rid of hollowness below eyes? (Photos)

Answers (14)

More Botox Questions

It's said that one's face returns to 'normal' once the effects of Botox wear off. Is normal the same as 'how it was before'?

Botox to DAO muscle and platysma - do these muscles that depress the lower face become more active as people age?

What recommendations other than Botox/Dysport can you recommend to eliminate these eye wrinkles and crepey skin? (photo)

Can Botox be used to lift the cheeks and middle of the face?

What is this bulge in between my eyebrows? It stays here even with Botox. How can I get rid of this? (photo)

Why should someone with an autoimmune or muscle disorder not get Botox or Dysport in the forehead?

WE SEND PRETTY
EMAILS