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Hollow Cheeks
  • Sunken cheeks are an inevitable part of aging for many of us. They develop when the body slows its production of collagen and subcutaneous fat.
  • Other factors, such as sudden weight loss, smoking, poor lifestyle choices and certain diseases, can cause cheeks to recede and sink into the face.
  • Several tried-and-true treatment options are available to help you plump up those cheeks in no time flat, including fillers and surgery.
  • Natural remedies and facial exercises may be a good, low-cost option for people who don’t want to invest in a professional cosmetic procedure, but most have not yet been proven to be effective.

Although not so long ago sunken cheeks, dark circles and a bony figure were the trends du jour of high-fashion — just take a look at Naomi Campbell and Kate Moss at the height of their careers — these days beauty is all about the full and plump. And we’re not just talking about the face and lips. Unfortunately, it’s an inevitable part of aging: our skin begins to thin, sag and generally lose its luster. One of the ways aging skin affects how we look is through hollow, sunken cheeks.

Hollow cheeks appear to recede inward into the facial bones rather than project outward. This creates a more prominent jawline and highlights the cheekbones. Although some people like the look of such depressions on the face — it creates a slimmer appearance — others see them as markers of age.

If volume loss in your cheeks makes you feel self-conscious, then you might want to consider a cheek augmentation procedure.

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Causes of Sunken Cheeks

As we get older, our bodies produce less and less collagen. Except we need collagen for healthy skin; it’s to thank for the skin elasticity and plumpness we all took for granted in our youth. When our skin doesn’t have enough collagen, it starts to sag, wrinkle and dull.

But collagen isn’t all that we lose as we age. Our bodies also stop producing as much subcutaneous fat, the subdermal fat that makes our cheeks and face plump, and may also stop supporting the muscle structure that contributes to more rounded and less bony facial features.

What’s more, the fat pads found in our cheeks begin to fall over time due to gravity, leaving behind, quite literally, sagging skin and bones. More visible nasolabial folds, which deepen as we age, will also contribute to a hollow look.

Besides aging, there are several other reasons why a person might develop hollow cheeks. Poor diet or starvation can cause significant fat loss that leads to a sunken appearance, while smoking and poor skin health can cause the blood vessels to stop delivering essential nutrients to the facial skin. Certain diseases or illnesses — especially those that cause rapid weight loss, such as anorexia — can compromise cheek fat and lead to that hollow, sunken look.

Treatment for Sunken Cheeks

Most sunken cheek treatments focus on the plumping factor — fillers, for example — but certain surgical procedures can also be used to permanently boost cheek volume. Which one is right for you depends on your particular situation, budget and desired results. Many plastic surgeons recommend a combination of several treatments for the best results.

Soft Tissue Fillers

Soft tissue fillers and hyaluronic acid fillers like Juvéderm, Restylane, and Radiesse are probably the most common options for treating hollowed cheeks. These treatments are injected directly into the mid-face or hollowed section to volumize the malar (cheek) area. This non-surgical cheek enhancement option is an ideal choice for people who want a quick and simple treatment, but there are some cons.

The primary pitfall of cheek fillers is that they’re temporary, with each treatment lasting between six months and a year. As a long-term solution, dermal fillers can become costly and require a lot of maintenance. The cost varies based on which type of injection is used, but you can expect to pay between $500 and $1,500 per treatment.

Fat Grafting

Structural fat grafting (also known as fat transfer or microlipoinjection) on the other hand, is a permanent solution. During this procedure, the patient is treated under anesthesia and the fat usually removed from the thigh or abs. Fat grafting requires the removal of fat from one part of the body (usually through a needle or syringe, but sometimes via surgery) and then the injection of that fat into the cheeks.

In other words, a doctor will literally take fat from another part of your body to supplement your existing cheek fat. The cost of a facial fat transfer varies widely, but you can expect to pay between $4,500 and $8,200, depending on your anesthesia preferences and a few other factors.

Cheek Implants

Another permanent solution, cheek implants are designed to increase the projection of the cheekbones and to add volume to flat, recessed or hollow areas. A plastic surgeon will implant body-safe implants typically made of solid flexible silicone or a more rigid porous material.

Interestingly, because the surgery is simple and low-risk, doctors are able to remove cheek implants relatively easily should a patient be unhappy. Of course, like any surgical procedure, facial implants require a significant recovery period. Most people experience slight bruising, swelling and pain for approximately one week after surgery.

According to the American Society of Plastic Surgeons (ASPS), the average cost of cheek implants in the United States is $2,823.

Collagen Stimulators

Another kind of injectable that can help plump sunken cheeks is the collagen-stimulating injection. Brands like Sculptra® are touted as great alternatives to regular soft tissue fillers, which can sometimes cause an “overstuffed” look. Collagen fillers are made of synthetic lactic acid, which helps the body restore its own natural collagen tissue. The result is a more natural and elastic appearance.

This collagen stimulator is also gaining steam against Juvéderm and other popular hyaluronic acid fillers because it lasts longer. Most people report that their results lasted about two years. For this reason collagen stimulators can be more expensive than regular fillers.

What About Facial Exercises and Home Remedies?

If you have a genuine fear of needles or going under the knife, don’t stress. There are a few natural remedies that you can try to restore volume to your cheeks and face as a whole. Some claim that giving your face some good exercise — like holding your mouth closed and filling it with air, for example — helps tone and tighten sagging facial skin (and maybe even get rid of that double chin while you’re at it), which contributes to a hollow appearance.

But do they actually work? Medical professionals are at odds. Some say a regular facial exercise program will contribute to a more youthful appearance by toning facial muscles, which in turn helps the skin to appear firmer. But there’s little scientific evidence to back this up. We do know that facial exercises burn calories, which could possibly bust those precious few facial fat cells you have left, so perform your facial pull-ups and push-ups at your own risk.

Then there’s the question of natural remedies. You may know that some naturally derived skincare ingredients claim to boost collagen production, which will certainly contribute to a healthy, plump face. Ingredients like vitamin C, hyaluronic acid and antioxidants are said to increase the skin’s ability to produce collagen. Some people also claim that using moisturizers that are high in fatty acids (such as shea butter) will also enhance the skin’s elasticity.

The Next Steps

If you’ve decided that you’d like to pursue a professional cheek augmentation procedure to help fill out your fat-starved cheeks, the next thing to do is find a board-certified plastic surgeon in your area. He or she will be able to tell you which treatment is most appropriate for your specific needs and budget.

And with the right treatment tailor-made to your situation, you can expect to acquire super-plump, round and squeezable cheeks with minimal hassle.

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