Filler not working for dent on cheek - what else I can try? (photos)

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

The dent that is seen in the photos may actually not be the problem. More likely the indentation seen there (that is emphasized by smiling) is really an artifact of the presence of the "puffy pillow" of the upper cheeks directly under the eyes. So when this "mountain" becomes pronounced with smiling, the dent, like a valley, becomes accentuated. Under-eye puffy pillows, which can actually result from filler treatments, and may have been accentuated further by such treatments, are the result of lymphatic edema/obstruction. If this is the case, it can be a difficult problem to treat. I have been able to achieve gratifying results with such problems using an algorithm of varying combinations, concentrations and amounts of intralesional anti-inflammatory agents. You would be wise to make sure to consult with an experienced, board certified cosmetic dermatologist. Best of luck.