Sunken Cheeks: Causes, Symptoms & Treatments

Sunken cheeks occur when a person doesn't have a lot of flesh between the bony arch of cheek under the eyes (zygoma) and the lower jawbone (mandible). As we grow older, we lose facial fat which gives our cheeks a youthful ‘plumpness’.

Tagged: Facial Treatments

What are sunken cheeks & what causes them?

Sunken cheeks are just another example of how our facial features age. Sunken cheeks occur when a person doesn't have a lot of flesh between the bony arch of cheek under the eyes (zygoma) and the lower jawbone (mandible). As we grow older, we lose facial fat which gives our cheeks a youthful ‘plumpness’.

Although age is a major cause of sunken cheeks there are a number of other things which may result in this condition.

You may develop hollow cheeks due to illness, such as Ehlers-Danlos syndrome (an inherited condition caused by collagen defects), lipoatrophy (a loss of facial fat commonly associated with HIV), advanced tuberculosis and eating disorders such as anorexia or bulimia nervosa. 

Other causes of hollow cheeks include dehydration, malnutrition, smoking, a lack of sleep, and harsh weather conditions. You may also find you have sunken cheeks after weight loss.

Sunken cheeks are not exclusive to one particular sex as both men and women can have them.

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What happens to cheeks as we age?

Collagen is a protein which is found throughout the body, including in the skin. This protein keeps our skin looking young and plump, but as we age our collagen levels deplete. This leads to sagging skin. As we age we also lose the fat located just beneath the surface of the skin (subcutaneous fat) from around the eyes and mouth. Although over time this fat is lost, our bone structure does not change. The combination of these factors can result in the appearance of sunken cheeks.

Surgical or non-surgical procedures to restore fuller cheeks can help to turn the clock back by up to ten years.

What surgical options are there?

Fat transfer, also referred to as fat grafting and lipofilling, is an excellent surgical treatment which can achieve fuller cheeks.

The method involves taking fat from one part of the body, such as the stomach, thighs or buttocks, via liposuction. These cells are then cleansed and processed via centrifugation before being reintroduced into the body, adding volume in ageing areas of the face, including the cheeks. Fat transfer simultaneously rejuvenates the overlying skin, restoring a more youthful appearance.

Fat transfer is a very quick procedure, taking just 30 to 45 minutes to complete. Fat transfer to the face is performed under local anaesthetic and is a day-case procedure, meaning there is no need for an overnight stay and you can recover from the procedure in the comfort of your own home. The results are long-lasting, natural and immediate.

Fat transfer to create fuller cheeks can also be combined with other surgical procedures on the face, such as a face lift and upper and lower eyelid reduction. Book a consultation with one of our expert surgeons to discuss the options available to you.

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What non-surgical options are there?

Dermal fillers are a quick, effective, non-surgical option to tackle the problem of sunken cheeks.

These injectable treatments fill out hollow cheeks to recreate voluminous, youthful skin.

The active ingredient in dermal fillers, hyaluronic acid, is naturally found in the skin, and combats several signs of ageing, including hollow cheeks.

At the Cadogan Clinic we use temporary fillers which dissolve over time because these are the safest option carrying the lowest risk of any long term side effects. The two brands we use here at the clinic are Juvederm and Restylane. Both are industry leading fillers and are two of the most popular brands on the market today.

There is no need for a general anaesthetic and dermal fillers leave no scarring. The treatment takes just 10 to 15 minutes and there is no downtime, meaning you can return to work and your daily routine immediately. Dermal fillers are effective and the treatment results in natural-looking fuller cheeks.

What at-home options are there?

Eating a healthy balanced diet and keeping hydrated by drinking six to eight glasses of fluid a day, will help with the appearance of hollowed cheeks if a poor diet or dehydration is the root cause. This will also contribute to better general overall health. It is important to maintain a healthy weight.

A 2018 study has shown that facial exercises may help to stop or even reverse the appearance of sunken cheeks. The study found that people who did 30 minutes of facial exercises every day had firmer and more youthful-looking faces. These exercises work by toning the facial muscles. Such exercises include closing your mouth and filling your cheeks with as much air as you can hold. Then, after 45 seconds, slowly releasing the air.

Although there is evidence that facial exercises can help to keep sunken cheeks at bay, of course this cannot stop the ageing process and we would recommend considering dermal fillers or fat transfer for a more long-lasting result.

Other at home remedies include the consumption of aloe vera gel. A 2009 study showed that women who consumed a teaspoon of aloe vera gel every day for 90 days showed improved facial elasticity. There are plenty of creams, lotions and serums on the market which claim to help restore volume to sunken cheeks. There is often little scientific evidence to back up these claims. 

Apart from maintaining a healthy weight and eating and drinking well, the only sure fire way to tackle the problem of sunken cheeks is with dermal fillers or a fat transfer procedure. We would recommend making an appointment with one of our expert consultants here at the Cadogan Clinic to discuss a treatment which will provide a guaranteed result.

Treatments mentioned in this article

As we age, the skin on our face starts to lose its elasticity and begins to sag. Creases can become deeper and the jaw and neckline start to droop. Fat on the face, which makes it look plump and smooths out wrinkles, is absorbed as the years go by, so the face appears more gaunt. The rate at which this ageing process occurs varies from person to person and can be a source of frustration for those who want to look as young as they feel.

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Dermal fillers such as Juvederm, Restylane, Hyalronic Acid and Sculptra are very popular, quick injectable treatments that can soften facial wrinkles, lines and fill out hollows to recreate the smooth contours of younger skin. Fillers are popular with those seeking a swift, non-surgical solution for ageing skin that has lost volume as the collagen that previously helped to shape and support it has disappeared.

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Fat transfer (fat transplantation) uses processed fat from your own body to re-contour and restore volume to facial areas that have become sunken with age, thereby rejuvenating your face and restoring a more youthful appearance. This may be achieved using the fat transfer technique.

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Focussed on removing excess skin around the face, jaw and neck areas, the mini-facelift is an ideal treatment for people wanting to achieve a more youthful appearance without undergoing a full facelift procedure.

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The visible signs of facial ageing, such as lines, wrinkles and loose skin, can now be reversed with the help of both non-surgical treatments or (for a more permanent outcome) a surgical facelift.

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