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Apple cheeks are associated with a healthy glow, a sweet look, approachability, and popularity, so many women start taking special care of their apple cheeks or filling them. Whether natural or acquired, apple cheeks begin to sag and be lost over time, either returning to their original state or becoming sunken and saggy. This article analyzes the causes of sagging apple cheeks and the resulting facial changes, and rounds up how to lift apple cheeks, key points, and common questions about aesthetic medicine for apple cheeks, so you no longer have to worry about what to do about sagging apple cheeks. With a professional doctor's help, you can re-sculpt your facial contours and easily keep your skin youthful and firm.
What Are Apple Cheeks, and Where Are They?
First, let's find out what “apple cheeks” are. They are not a muscle but a group of midface tissues under the eyes, located from the lower orbital rim to both sides of the nostrils, about 2 cm below the eyes, in an inverted-triangle shape. Apple cheeks show no obvious fullness when we are not smiling, but when we smile, muscles and ligaments compress them and they puff up slightly, forming a full, rosy, apple-like curve that gives a sweet, approachable, girlish look, which is why they are also called “lucky cheeks” or the “smile muscle.”
How Can You Tell If Your Apple Cheeks Are Sunken?
Once you know you have apple cheeks, you can check for signs of sinking through the following four changes:
1. Jowls Appear
Apple cheeks are fat pads wrapped in a fascial layer, so with age and aging, as the fascia gradually loses tension and sags, the fat pad, that is the apple cheeks, sags with it, causing slack cheeks and enlarged jowls, so the overall facial contour loses dimension and firmness.
2. Deeper Nasolabial Folds and Marionette Lines
When the tissue support of the apple cheeks weakens, they begin to sag under gravity, pushing out nasolabial folds and marionette lines or making wrinkles deeper. The apple cheeks may even pull the fascia downward and cause forehead lines to appear! This makes the face look older.
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3. A Flatter Side Profile
If the apple cheeks lose support and become sunken, and the tissue shifts downward, the midface line visually droops and the side profile becomes flat and saggy. Once the side profile flattens, you look older and tired.
4. Double Chin
Once apple cheeks start to sag, fat accumulates in the mid-to-lower face. Besides flattening the face shape, it presses on other parts of the face, and because the sagging fascial layer blurs the jawline, a double chin appears over time.
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Why Apple Cheeks Sag
1. Congenital Factors
Some people are born with flatter facial bones or less support, which easily makes apple cheeks look sunken and sagging. If apple cheeks sag at a young age, it may be related to innate bone structure!
2. Acquired Factors
Many women, concerned about their figure or body shape, often “lose weight” to sculpt their ideal shape. But if it is done incorrectly, or weight drops quickly or fluctuates widely, fat is lost rapidly in a short time, large gaps form between the skin and bone, and sagging results.
In addition, orthodontic treatment, chewing habits, and tooth extractions can all indirectly contribute to hollow cheeks, making the apple cheeks lose their fullness and firmness!
3. Natural Aging
With advancing age and the effects of a poor lifestyle and environment, such as staying up late and stress, the collagen, fat, and water in our bodies gradually decline. Once the deep skeletal structure and deep fat are lost, the soft tissue above sags, leaving the apple cheeks sagging and collapsed.
Aesthetic Medicine Options for Lifting Apple Cheeks
(1) Hyaluronic Acid: Sculpt the Contours (for Sunken Apple Cheeks)
Hyaluronic acid is an important moisturizing component found in the dermis of human skin, helping maintain elasticity and lock in the skin's moisture. Women who care about their looks can get it in advance as maintenance. When hollows are not yet very obvious, injecting hyaluronic acid can effectively help skin replenish and retain water, instantly fill hollows, and refine facial lines, sculpting more dimensional contours!
For people over 35 with obvious laxity or hollowing, consider collagen stimulators, which stimulate collagen production in facial skin, rebuilding the skin's deep framework and lifting slack lines upward to address aging at its root.
In general, sagging apple cheeks come with other problems, such as hollow nasolabial folds and facial laxity. If the apple cheeks come with nasolabial folds, NAISS CLINIC recommends improving them with large-molecule hyaluronic acid filler, which fills the nasolabial folds while lifting the apple cheeks.
P.S. Because everyone's skin ages differently, the age ranges are for reference only. The actual situation still needs to be evaluated and diagnosed by a professional doctor, who will recommend the most suitable treatment!
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(2) Facial Lifting: Strengthen the Foundation (for Slack-Type Apple Cheeks)
As mentioned above, apple cheeks often come with laxity, so we recommend a combined approach, such as ultrasound lifting (HIFU) delivered to the deep fascial layer and the superficial dermis and epidermis, comprehensively lifting the apple cheeks so they tighten upward and inward. Three months after the procedure, large-molecule hyaluronic acid can be injected where the apple cheeks are still lacking, so the overall result is both firm and plump.
How ultrasound lifting works: it is mainly used to lift sagging skin and enhance the contours, heating through single-point focusing to deliver energy to the subcutaneous fascial layer and help it contract and reorganize. Slight changes can be seen right away, and as collagen increases, changes can be seen in about 1-2 months, with results becoming more obvious at 3-6 months!
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This article is for general information only. Results vary from person to person; please consult a doctor in person before deciding on any treatment.
