Hollow front cheeks and hollow side cheeks: why do they form, and what fills them?
“My front cheeks have sunk, so I look tired.” “My side cheeks have hollowed, so my cheekbones stick out.” Both get called ‘hollow cheeks’, but in the treatment room the place and the reason are quite different. So the way to fill them differs too.
The short answer
Hollow front cheeks come from shrinking fat at the front of the cheekbone below the eyes, and hollow side cheeks from a dip below the cheekbone and in front of the ear. Facial fat is divided into compartments, and each compartment shrinks differently. For filling hollow cheeks, much of the evidence is for hyaluronic acid filler. In randomised trials with no-treatment controls, 76–86% had improved at 6 months, and around half still held the result at 1 to 2 years. Hollow side cheeks can also appear after masseter botox or rapid weight loss, so I look at the cause first. At Miso Clinic, 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu (Exit 1, Kyungpook Nat'l Univ. Hospital Station), +82-53-428-2700, dissolvable hyaluronic acid filler is considered first.
How do front and side cheeks differ?
| Aspect | Hollow front cheeks | Hollow side cheeks |
|---|---|---|
| Where | Front of the cheekbone below the eyes | Below the cheekbone, in front of the ear, side of the cheek |
| How it looks | Shadows under the eyes grow longer and you look tired | Cheekbones look prominent and the face looks angular |
| Common reasons | Ageing fat compartments shrinking and sinking | Weight loss, muscle shrinkage after masseter botox, natural face shape |
| Considered first | Hyaluronic acid filler | Filler or collagen boosters, after checking the cause |
Why do cheeks hollow compartment by compartment?
Facial fat is not one single mass. A study that dissected 30 cadaver hemifaces confirmed that the fat under the facial skin is made up of several separate compartments, and that the fat over the cheekbone alone is divided into three. The researchers took the view that the face does not age as one block but changes compartment by compartment.
That is why only the front cheek, or only the side cheek, can hollow. When one compartment shrinks, its border with the next one shows like a shadow. This is why I choose compartments to fill instead of filling the whole cheek at once.
If I fill them with filler, how long does it last?
For midface (cheek) volume filler, there are several randomised trials with no-treatment controls.
- 282 people — 85.6% had improved by at least one grade at 6 months, and nearly half held it to 24 months
- 148 Chinese people — 76% vs 8% with no treatment at 6 months, and 51% still held it at 12 months
- 238 Asian people — 82.0% vs 5.1% with no treatment at 26 weeks, 76.2% at 52 weeks
All were funded by the product makers, so read them as a range rather than taking them at face value. Even so, the control-group numbers clearly show that “the side that had nothing done barely changes”.
Can hollow side cheeks come from masseter botox?
Yes, they can. When the masseter muscle shrinks, the side of the cheek above it sometimes looks hollow along with it. In that case I first adjust the botox interval and dose, and filling comes after that.
Some people also find their side cheeks hollow first after losing weight quickly. I have written about this separately in the column on whether running makes your face sag.
→ More: Does running make your face sag?
What do you check before filling?
- Hollowing or sagging — strong lifting first on a hollowed face can make it look even more gaunt
- Recent weight change — if weight loss is still under way, I sometimes put off filling
- History of masseter botox — adjust the interval and dose first
- Whether it can be reversed — start with dissolvable hyaluronic acid filler
Collagen boosters (Juvelook Volume, Sculptra, Radiesse and so on) come into the conversation after that. They fill in gradually, but are hard to reverse.
→ More: Facial sagging consultation: telling hollowing from sagging
Hollow front and side cheeks: frequently asked questions
Why do my front cheeks look sunken?
Facial fat is divided into several compartments, and when the compartment at the front of the cheekbone shrinks first, the front cheek looks sunken.
How long does cheek filler last?
In randomised trials, 76–86% had improved at 6 months, and around half still held the result at 1 to 2 years. It varies from person to person.
Can massage or exercise fill hollow cheeks?
I could not find a study showing that massage or facial exercise refills hollow cheeks.
Where can I get a hollow cheek consultation in Daegu?
At Miso Clinic, 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu (Exit 1, Kyungpook Nat'l Univ. Hospital Station), +82-53-428-2700. Weekdays 11:00–19:00, Saturday 10:00–16:00, closed Sundays and public holidays.
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Related treatments: Nasolabial folds · Lifting · Types of facial wrinkles
Who wrote this
Written and reviewed by Lee Chi-Hak, MD, director of Miso Clinic, Daegu. The treatment standards and injection design set out here are the ones we use in practice.
| Medical director | Lee Chi-Hak, MD |
|---|---|
| Address | 4F Bombom Building, 125 Dongdeok-ro, Jung-gu, Daegu, South Korea · Exit 1, Kyungpook National University Hospital Station |
| Phone | +82-53-428-2700 |
| Hours | Weekdays 11:00–19:00 (lunch 13:00–14:00) / Saturday 10:00–16:00 (no lunch break) / Closed Sundays and public holidays |
| Columns | All clinical columns |
| Reference library | All booster and device references |
References
- Facial fat compartments — Rohrich RJ, Pessa JE. The fat compartments of the face. Plast Reconstr Surg 2007;119(7):2219-27. PMID 17519724. 30 cadaver hemifaces.
- Randomised trials of midface (cheek) volume filler — Jones D, Murphy DK. Dermatol Surg 2013;39(11):1602-12. PMID 24093664 (282 people, 2 years) / Ren R et al. J Cosmet Dermatol 2024;23(6):1985-91. PMID 38487954 (148 people, 12 months) / Yu N et al. Aesthetic Plast Surg 2026;50(3):776-85. PMID 40987843 (238 people, 52 weeks). All with no-treatment controls, all manufacturer-funded.
- Korean medical advertising law — Korean Medical Service Act Article 56(2) (no treatment testimonials, no comparisons with other clinics, no superlatives). This is why this column carries no prices, reviews or before-and-after photos.
- Miso Clinic practice guidelines — for hollow cheeks, dissolvable hyaluronic acid filler is considered first; botox is offered for all areas of the face; no RF treatment that day if there are metal or electronic implants, pregnancy or skin inflammation.
Everything in this column is general information and does not replace medical diagnosis or treatment. Effects and side effects vary with individual skin condition, age and underlying illness, and the same result is not guaranteed for everyone. Any decision to proceed should be made in an in-person consultation with a physician.