Q: I want a fuller face with full cheeks. I have a very thin face that looks gaunt and sunken. It seems to be getting worse as I age. I think I need either cheek implants or fat injections but am not sure which is best. I have attached some pictures of my face for you to see and do some computer imaging to see what the possible changes would be. Thank you for your time.
A: Thank you for sending your photos. To do accurate imaging, however, a front and side view photo is needed in which one is not smiling. Your photos can not be used for any imaging as the smile obscures the whole process.
Otherwise, you have a type IV facial lipoatrophy condition with near complete loss of the buccal fat pads and most of the subcutaneous fat tissue. This gives you that sunken facial appearance. You would ideally benefit from a combination of submalar cheek implants combined with concentrated fat injections to the upper and lower submalar area as well as back along the side of the face. Given your thin face, it may well be that your body is equally thin so whether you have enough donor fat remains to be determined. With fat concentration techniques, one needs to harvest as least twice as much fat as the face requires. I would estimate that you need about 20cc of fat for each side of the face so it would take about 100cc of liposuctioned fat to do the job.
Dr. Barry Eppley