What Causes Sunken Cheeks?
Sunken cheeks can present various challenges for facial plastic surgeons. The contour of the cheeks is determined by a combination of the underlying facial skeleton and the overlying soft tissues, including fat, supportive tissue, and salivary glands. Factors leading to sunken cheeks may range from an individual’s natural anatomy to changes associated with aging, disease processes, or medications. Depending on the specific cosmetic issue, a variety of techniques may improve the appearance of sunken cheeks.
Causes and Treatments
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Deficient Bony Structure of the Midface
In patients with a deficient bony structure of the midface and upper cheek, the soft tissues lack support and may appear excessively lax or droopy. Facial aging also leads to bone remodeling, resulting in the loss of support for midfacial fat pads and the appearance of volume loss. The most direct solution for this issue is the placement of cheek implants. These permanent implants augment the facial skeleton, providing additional projection and support. They come in various sizes and shapes and may even be custom-made for individuals. In some cases, facial asymmetries from genetic factors or trauma can be corrected. Additionally, fillers such as calcium hydroxyapatite and high G-prime hyaluronic acid can help correct skeletal problems by being placed immediately along the bone.
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Soft Tissue Volume Loss
For patients with soft tissue volume loss, the solution is usually to replace the volume deficit. Several fat compartments of the midface, including deep fat pads beneath the orbicularis muscle, in the medial cheek, and the buccal fat pad, may change position or conformation with aging. Superficial fat pads include the medial and lateral malar fat pads and a separate fat pad along the nasolabial fold. Restoration of this soft tissue appearance is commonly performed with hyaluronic acid fillers or fat transfer.
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Broad Deficits in the Cheek
In some cases, broad deficits of the cheek are seen from parotid gland wasting or globally diminished fat in the central cheek. This is becoming more common with the advent of semaglutide medications used for weight loss. Fillers can also be helpful in this situation. Broad-based defects in the central cheek and temple areas are often best treated with poly-L-lactic acid (Sculptra).
Treatment Options
Sunken cheeks and facial volume changes are often readily treated with office procedures. Depending on the underlying problem and desired result, surgical solutions may also need to be considered. Dr. Beaty has over 20 years of experience with both surgical and non-surgical management of the aging face, having performed thousands of facial procedures and participated in clinical trials and product development. He is available for consultation to determine the best procedures for you.
Contact Us
If you’re concerned about sunken cheeks and want to explore your treatment options, contact Dr. Beaty today to schedule a consultation. Discover how his expertise can help you achieve a rejuvenated and youthful appearance.
