In this article
Cheek implants rank 32nd out of 34 cosmetic procedures for good reason—most people don't need them. Yet I regularly see women who've gotten cheek implants when they needed something entirely different. The problem isn't their cheekbones. It's that their cheeks have fallen.
The Real Problem: Cheek Ptosis, Not Flat Cheekbones
Most women seeking cheek implants have perfectly normal or even prominent cheekbones already. What they're experiencing is cheek ptosis—the gradual sagging of facial fat that happens with aging. The fat pad that once sat high on the cheekbones slides down into the lower face, creating a squared-off appearance.
This downward migration leaves the upper cheeks looking hollow while making the lower face appear heavy. The cheekbones lose their youthful fullness, but adding implants won't solve the underlying problem of sagging tissue.
Why Cheek Implants Often Miss the Mark
Cheek implants increase bone prominence, but they can't restore the soft, natural fullness of youth. When placed over already adequate cheekbones in someone with cheek ptosis, implants create a bony, angular appearance. Bony faces don't look young—they look aged.
More importantly, implants do nothing to address the sagging that created the problem in the first place. The fallen fat pad remains in the lower face, and the overall facial shape stays squared off.
When a Midface Lift Is the Better Choice
A midface lift addresses cheek ptosis by repositioning the fallen fat pad back onto the cheekbones where it belongs. This restores the face's natural youthful contours without creating an artificial, over-augmented appearance.
The results look natural because you're working with your own tissue, just putting it back where it used to be. The cheekbones regain their soft fullness, the lower face becomes less heavy, and the overall facial shape returns to its more youthful oval.
Who Actually Needs Cheek Implants
Some people genuinely have underdeveloped cheekbones that benefit from augmentation. These patients typically have naturally flat or recessed cheek areas that have always lacked projection. For them, cheek implants provide the structure their face never had.
But in my practice, I see about ten candidates for midface lifts for every one person who truly needs cheek implants. The ratio tells the story—most people are misdiagnosing their own problem.
Making the Right Choice for Your Face
The key is understanding what's actually happening to your face with aging. If you had good cheekbone projection when you were younger and now feel your cheeks look flat, you're probably dealing with sagging, not inadequate bone structure.
Look at photos of yourself from 10-15 years ago. If your cheeks looked full and defined then, a midface lift will likely give you better, more natural results than implants.
Frequently Asked Questions
Can cheek implants be removed if I don't like the results?
Yes, cheek implants can be removed, but removal may leave you with the original sagging that wasn't addressed. If cheek ptosis was the real issue, you'll still need a midface lift after implant removal.
How do I know if I have cheek ptosis or flat cheekbones?
Compare current photos to ones from your twenties or thirties. If your cheeks looked full then but appear hollow now, you likely have ptosis. If your cheeks have always looked flat, you might benefit from implants.
Is a midface lift more invasive than cheek implants?
A midface lift involves more surgical technique than implant placement, but it addresses the root cause of facial aging. The recovery is comparable, but the results typically look more natural and last longer.
Ready to determine whether cheek implants or a midface lift is right for your goals? Schedule a consultation to discuss your specific concerns and get an honest assessment of what will give you the best results.
Related Procedures
Questions about this procedure? Dr. Schwartz will give you a direct, honest answer at your consultation.
Back to Journal