Restoring mid cheek volume loss case study

case study Sep 07, 2023

This week I would like to discuss my recent client, who has just turned 50.

This lady is a regular client for softening of forehead and eye wrinkles, but had started to feel sunken, drawn and tired looking on the mid and lower face and couldn't put her finger on why.

On examination, it was evident that volume loss and flattening had began to appear to the mid cheek area and there was some loss of projection around the cheekbone area.

Changes can be mild at first, but over the years, if not addressed, this deflation can cause a sausage type fold above the nasolabial fold, which can the press down on the lower third of the face, making folds appear deeper.

For those of you who have completed my advanced dermal filler training, I explain in detail what is going on anatomically to cause these changes.

In brief we have fat pad separation and changes in fat pad volume happening under the skin, along with bone shrinkage and changes in elasticity to the actual skin.

When these changes first begin, surface level the client will begin to see lines appearing from the corner of the eye, across the cheek in a diagonal fashion.

They may also start to feel flat, sunken and longer in the face.  I will often hear clients say

"I used to have apples on my cheeks, but they've disappeared'


"My face doesn't feel as full as it used to"


"I feel like my cheekbones have disappeared"


"I look drawn and tired and don't know why"

If you possess knowledge on what is happening anatomically and how this reflects what they see, clients then begin to build up trust with you and can see how treating the face as a whole, not just on isolation is the ultimate goal.

For instance.  Deflation of the cheek may be causing:

Worsening of nasolabial folds and  / or jowls

Lines above the lip

All from volume deflation higher up, pressing on these lower areas.

Being able to restore this area safe and effectively, whilst keeping it very natural is a combination of science and art.

Area of restoration

Benefits of being able to do this include

  • Higher trust and confidence building from clients
  • Better client retention (clients won't look elsewhere for treating this area)
  • Increase in revenue 
  • Ability to treat the face as whole, not in isolation.

You can see below on the before and after image how natural the effects of restoration are.

The drawn look  / lines on the midcheek have softened and the area looks a tad more fuller and youthful, the apples of cheeks returned, without looking too much.

The cheek bone area has also been gently restored to give slightly more projevtion.

Face now appears more heart shaped, as opposed to elongation.

The face looks very slightly lifted.

This was achieved using just under 2 mls of Juvederm 4.  Juvederm Voluma could also be used.

Advanced Dermal Filler Training is a fully accredited certification, but I also offer an online version at a reduced price, for those who already have advanced certification and just require some extra confidence, skill or knowledge building.

I hope you found this useful 


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