What Causes Hollow Cheeks
The aging, hollow face is typified by soft tissue decent and volume loss. These stigmata of growing older are manifest by the development of nasolabial folds, marionette lines, and jowls combined with a sunken mid-face and hollow cheeks.
In recent years, DeLuca Plastic Surgery has looked past skin tightening as the solution for all of these complaints and has recognized the role that volume loss contributes to the appearance of aging, hollow cheeks. This volume loss occurs as the soft tissue (and even bone) of the face resorbs over time as we get older or secondary to weight loss. To combat these changes we utilize a variety of techniques including several types of non-invasive facial fillers, fat transfer, and facial implants.
Projection of the cheeks and mid-face is due to the interaction of the bones of the face and the overlying skin and soft tissue. Facial implants are used to add a more substantial foundation to hollow cheeks by adding projection to the bones of the face in patients that have experienced significant resorption as they age or who have always lacked projection. Skeletal implants are powerful tools to modify the framework of the face and can produce dramatic results. In our practice, these implants are often combined with soft tissue augmentation, such as fat transfer, to treat hollow cheeks – restoring harmony and symmetry.
Botox is an injectable used to lessen the movement of specific muscle of the face in an effort to target wrinkles created by the contraction of facial muscle groups. The areas that are treated most often include the forehead, the area between the eyebrows, and the crows feet (on the side of the eyes). The goal is to soften these tell-tale stigmata of aging without leaving the face looking flat and emotionless. This can be a difficult needle to thread. If done correctly, however, Botox can make the face look younger, raise the eyebrows, and make the eyes look more open.
Botox is injected using a very fine needle into the affected areas. Most patients experience little discomfort and by the time they return home or to the office any redness or swelling has disappeared. The affect begins to be noticed over the next week and lasts for about 3-6 months until the effect, again, slowly fades out.
Question – Below my cheekbone a hollow channel is inching towards the center of my face. I had a facelift two years ago and cannot figure out what is causing this. What can be done to correct this?
The facelift was two years ago. 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. The doctor has assured me that this was not a thread lift. The hollow is about 1.25″ in width. The skin above it is taut and looks lifeless. The hollow keeps lengthening and it looks awful. What could be happening? And can anything be done to stop it and/or correct it? – via RealSelf
Answer – Given that your facelift was two years ago, there are a couple possible reasons for why your cheeks now appear hollow/sunken based on the details you provided in your question: One possibility is that your surgeon did more ‘pulling’ & ‘tightening’ of your skin and not enough/any fat or tissue reposition. Another possibility is that you’ve experienced some fat re-absorption within the cheek area in the 2 years since your facelift as a result of weight loss, changes in diet, and/or BMI. The good new is that there are a few ways to replace the volume you’ve lost, which I’ll detail below.
How an overly tight facelift can cause hollow cheeks
Question – How long does Botox last? What determines how long it will work for me?
Answer – In most patients, Botox lasts between 3-4 months. However, there’s quite a bit of anecdotal evidence suggesting that it’s possible for patients to achieve results that last up to 6, 9 or even 12 months after consistent, long-term and properly-administered use of the Botox product.
In other words, what determines how long the effects of Botox lasts is:
- the dosage (and whether or not it’s been properly diluted)
- the duration & consistency of use
- the skill/experience of the injector or surgeon who administers the injection
The x factor within the “consistent, long-term and properly-administered” conditional I included is, of course, “properly administered”. After all, consistent treatments over several years will matter very little if the wrong amount of Botox has been injected imprecisely/incorrectly. That’s why 2 of the 3 factors explored in this post address it (re: ‘dosage’ and ‘skill/experience of the Botox injector‘).
1. Dosage: Why injecting & diluting the proper amount of Botox = keyThe first factor that impacts the longevity of Botox’s winkle-reducing effects is the dosage. Botox is diluted for safe use regardless of the injection site, so the impact it has on the surface is largely dependent upon the amount of injections. The site of injection will determine the amount of injections you receive.