The aesthetic feature known as “hollow cheeks” describes the visual effect of a shadow beneath a prominent cheekbone, creating a sculpted, defined contour. Achieving this look relies on a complex interplay of skeletal anatomy, soft tissue volume, and the body’s natural aging process. Whether this appearance is universally achievable depends on a person’s underlying facial architecture, which dictates the limits of modification.
The Role of Underlying Facial Structure
The appearance of hollow cheeks is largely predetermined by the prominence of the cheekbones, specifically the zygomatic arch. This bony structure provides the anchor point for the face’s three-dimensional shape. When the zygomatic arch projects significantly outward, it naturally creates an overhang that casts a shadow onto the tissue below.
The relationship between the zygomatic arch and the lower jaw (mandible) establishes the facial planes that define the cheek’s contour. For some individuals, this skeletal relationship naturally results in a concave curve, or “hollow,” below the cheek’s most prominent point. If the skeletal structure is flatter or less projected, the potential for a defined shadow is structurally limited.
Influence of Body Composition and Aging
Beyond the foundational bone structure, the volume and distribution of facial fat play a significant role in determining cheek contour. The face contains both superficial and deep fat compartments. The amount of subcutaneous fat beneath the skin can mask or exaggerate underlying bone structure, but a reduction in overall body fat percentage often leads to a decrease in facial fullness, which may reveal more skeletal definition.
However, facial fat loss is not always uniform, and a person cannot “spot-reduce” fat from the cheeks through diet and exercise alone. The buccal fat pad, a deep fat compartment located in the lower cheek area, is particularly resistant to general weight loss and contributes significantly to a rounded, full-cheeked appearance.
Aging also profoundly influences cheek hollowing through changes in facial volume. As people age, the body’s production of structural proteins like collagen and elastin decreases, leading to a loss of skin elasticity. Furthermore, deep fat pads in the midface begin to deflate, and superficial fat pads may descend. This complex process of volume loss and fat shifting naturally creates a more hollowed, gaunt appearance later in life.
Non-Surgical and Surgical Methods for Enhancement
For those whose natural anatomy does not yield a hollowed look, various methods exist to enhance or create the desired appearance. Non-surgical options primarily involve creating the illusion of a shadow. These include contouring makeup, which uses darker shades to visually recede the area beneath the cheekbone. Targeted facial exercises are sometimes suggested, but they offer minimal structural change and cannot reduce the volume of the deep buccal fat pad.
More direct and temporary modification can be achieved with dermal fillers, strategically injected above the cheek hollow to augment the zygomatic bone. By adding volume to the cheekbone, the filler enhances the projection and creates a more defined transition that casts a shadow below. Results from hyaluronic acid-based fillers are temporary, typically lasting between six months and two years, offering a reversible way to test the look.
For a permanent reduction in cheek volume, Buccal Fat Removal (BFR) is the most specific surgical intervention. The procedure is typically performed under local anesthesia, where a small incision is made inside the mouth to access and remove a portion of the encapsulated buccal fat pad. BFR is generally best suited for candidates with a genetically full or rounded lower face that retains significant buccal fat despite a healthy body weight.
BFR is irreversible, and the removal of this deep fat can affect how the face ages. Since the face naturally loses volume over time, removing the buccal fat pad prematurely can potentially lead to an overly gaunt or skeletal appearance decades later. Consulting with a board-certified surgeon is necessary to weigh the benefits of immediate contouring against the risks of long-term volume loss and potential complications like asymmetry, infection, or temporary nerve injury.