Many people are concerned that their cheekbones are prominent and the area below them is sunken, making the center of their face appear constricted.
They often say that their face looks particularly shadowed and older in frontal photos.
This shape does not have a single cause; it's necessary to first determine what makes it appear that way.
Take just one minute to read this.
Same Shape, Different Causes
| Cause | Appearance |
|---|---|
| Cheekbones are naturally prominent forward or sideways | Upper part is emphasized, making the lower part appear more sunken |
| Volume below the cheekbones decreases | Shadows appear and lines are etched |
| Tissue sags downwards | Upper part becomes hollow, lower part becomes heavy |
In most cases, these three factors are mixed, so we first assess which factor has a greater proportion.
Why Filling Alone Often Doesn't Work
Adding volume to a sunken area will fill it in at that moment.
However, if the cause was sagging tissue, it means you are adding more volume to an area where weight has already accumulated. This could make the face appear larger or feel heavy.
If prominent cheekbones were the main reason, filling the lower part would still leave the contrast between the upper and lower parts unchanged.
First Approach: Adding Volume
This approach is suitable when there is an actual lack of volume in the sunken area.
There are methods that provide immediate filling and methods that induce collagen production over time, and the choice depends on your schedule and desired speed of change.
It is often more natural to distribute the volume by considering the overall flow of the face rather than concentrating it in one spot.
Second Approach: Addressing Skin Condition
Thin and weakened skin can make the same volume loss appear more deeply etched.
In such cases, addressing the skin's condition itself can sometimes have a greater impact on facial impression than simply filling. This approach involves multiple sessions.
Third Approach: Addressing Sagging Tissue
If the main cause is the downward pull of weight, we consider methods that target that specific layer.
In this case, starting with a filling approach would be misdirected. This is a point where simply changing the order can alter the outcome.
For deep layer sagging, you can refer to the article that explains which layer buccal fat sagging comes from.
Criteria for Determining the Order
We start by addressing the factor among the three axes that has the greatest impact on the overall impression.
If everything is addressed at once, it can be difficult to determine what caused the effect, and there is a risk of over-treatment. It is safer to proceed in stages, observing the reactions, and then deciding on the next step.
Recovery and Precautions
Swelling, bruising, and a feeling of thickness may occur, and the degree and duration can vary individually.
If multiple methods are performed on the same day, the reactions may be compounded, potentially extending the recovery period. We consider this in conjunction with your schedule.
It is safe to consult with medical staff before proceeding to confirm that the sequence is appropriate for your condition.
Frequently Asked Questions
Can it be improved with Filler alone?
If volume loss is the main cause, it can be helpful. If sagging tissue is the cause, a filling approach alone may not resolve it.
Should I avoid putting in too much?
Concentrating too much in one spot can make the face appear larger or feel heavy. It is better to distribute it by considering the overall flow of the face.
Which should I do first: address skin condition or add volume?
We start with the axis that has a greater impact on the overall impression. If thin skin is the main reason, that may be the priority.
How long do swelling and bruising last?
It varies depending on the area, method, and recovery speed. If multiple procedures are performed together, it may last longer.
How do I determine which axis my face falls under?
We examine the face from the front and side, assessing the degree of cheekbone protrusion, the volume of the lower part, and the extent of tissue sagging. Often, it's a combination, requiring a judgment to determine the predominant factor.
Visit and Consultation Information
O.N Clinic is located near Gangnam Station, making it easily accessible from the Sinnonhyeon area.
It is more accurate to determine which of the three axes has a greater proportion by directly examining the face. For any questions, you can conveniently inquire via Chat now for a consultation.
Author: Dr. Oh Seung-min (Chief Director, O.N Clinic; Graduated from Seoul National University College of Medicine; Academic Committee Chairman, Korean Association of Laser, Dermatology and Hair). For more details on his background, please refer to Meet Our Medical Team. First published 2026-08-16 / Last reviewed 2026-08-25
This article is for general informational purposes only, and appropriate treatment and results may vary depending on individual conditions.
