Of course, more often than not, hollow cheeks develop naturally rather than as a result of a facelift or facial surgery. Individuals with thin, low-fat faces can still end up with an excellent looking facelift, as long as care is taken to make the most out of the fatty tissue that’s available and if need be, restore volume to hollowed out areas *before* tightening and re-draping the skin. Patients with plenty of subdermal fat in the jowls and lower face often end up looking several years younger after facelift than equally aged patients with thinner skin because all of that fat can be moved back to where it was 10+ years ago, within the mid and upper face. In other words, patients who exercise a lot, have very little body fat and good bone structure often need more than a facelift to obtain the full, youthful look a well performed facelift creates. This 60 year old woman underwent a 4 lid blepharoplasty (eyelid lift) and standard facelift where the deeper fascia were placated and liposuction of the neck was performed.
A lot has happened since the 80s and 90s … we now have several ways to restore volume to areas of the face that have lost it (as a result of aging, weight loss, genetics, or even a overly tight facelift). One option to consider for facial hollowing before considering fat grafting, fillers or Sculptra would be to gain some weight.
Another option to replace lost volume in your cheeks after a facelift is autologous fat grafting. As discussed above, gaining a little weight often will help fill out hollow areas below the eyes, above the cheek and below the cheekbone. While mini and micro surgical face lift alternatives are available, I would advise you to consider minimally invasive dermal fillers to treat hollowing of the cheeks.
So please make sure to do your homework before selecting a plastic surgeon to perform your facelift or any other facial procedure such as blepharoplasty. If you have sub q put where temples are and down around cheeks could I still have a lower face lift with in 12mths of having sub q ?


On one cheek, just below my cheekbone and along the path of the lift, a hollow channel has been inching toward the center of my face. People who are underweight or have very low body fat often have hollowing of the cheeks because the more exposed the cheekbones are, the more shadowing there will be beneath them. But long-term, it became clear that the initial result benefited from post-operative swelling. It doesn’t cost any additional surgical fee, and there is no surgical risks, and it is completely reversible.
The reason for this is that fat does not survive particularly well in the hollow area under the cheek bones and should only be injected at or above the cheekbone but not below it. When injected properly by a surgeon with experience using the product, Sculptra can do an excellent job filling out a hollow area below the cheek bones.
Without seeing the patient in person, it is hard to assess their need for a facelift revision. The good new is that there are a few ways to replace the volume you’ve lost, which I’ll detail below. However, once the swelling subsided, their faces did not look quite as refreshed or youthful as the faces of patients with more subdermal fat. If you choose this option though, the cost could be significantly higher since it will require some minimally invasive liposuction to harvest the fat. All of these procedures, from facelift to Juvederm injections, require the steady hand and artist’s eye of a skilled and experienced plastic surgeon. No matter how a facelift may tighten up any excess skin, the contour of the face will still look the same, because there was no fat that could be lifted upwards to re-contour the face.


The reason for this was because the thinner facelift patients have far less saggy fat in the face to reposition into the areas of the upper and mid face that need it to create a fuller, more youthful looking appearance. For the best results, you may have to invest in several treatments before you reach the optimal level of volume replacement. However, Sculptra takes time to build up, is more expensive than other fillers like Juvederm and Restylane, and ultimately will need to be repeated every 1-2 years, although at a lesser amount than the initial treatment. If the hollow cheeks could be corrected with one of the three options above, I would not suggest a facelift revision. The soft tissue of the cheeks is actually located on the lower side of the cheek bone and as it falls, the cheek bone becomes accentuated while the skin below sinks inward.
I often recommend this injectable gel to my patients because of its longer-lasting results – up to two years or more according to their clinical studies.
Radiesse can give a more immediate improvement without as much down time as Fat transfer, but it can’t be used very close to the eye in the tear trough area. The need for a facelift revision will depend on the severity of the hollow cheeks as well as the patients wants and needs. During a consultation, I will talk to my patients to fully assess their situation and determine if a facelift revision is necessary.



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