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Cheek volumization: The Submalar Zone

Posted:2:46 p.m. Monday, July 14, 2014

By Anita Mandal, M.D.

Question: My face looks very hollow and old. I have high cheekbones but the hollowing is just below my cheekbones. Can the hollows be improved to make me more youthful without the “puffy” look?

Answer: The area under the actual cheekbone is called the submalar zone. Malar refers to the cheekbone and submalar is just under the cheek or malar bone.
With advances in facial cosmetic surgery and facial volumization continue, we now have a better understanding of how to improve the various facial zones. Filling the submalar hollow can require a tremendous amount of filler with high maintenance costs due to frequent repeat treatments. This submalar area tends to use up much more filler than other facial zones, sometimes resulting in wastage of filler due to its quicker dissapearance from this area.
Hollowing under the cheeks, or in the submalar zone, often tends to be partly due to loss of bone and fat over the cheekbone itself. For this reason, injecting filler at very specific points along the length of malar or cheekbone can improve hollowing under the cheekbone. Temporary fillers such as Voluma, Sculptra and Radiesse can be used, whereas long term fillers like Bellafill® can be more cost-effective.
Once adequate volume has been restored to the upper cheek or malar zone, residual hollowing under the cheek can be further improved by direct filling.
This approach of restoring volume to the area of the cheek above the actual hollow first followed by filling of the submalar hollow last can be both cost-effective, more youthful looking and give a more balanced facial appearance.
Careful consultation with a facial plastic surgeon who is skilled in both surgical anatomy and advanced injectable filler techniques is the first step in addressing rejuvenation of facial hollowing.

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