High cheekbones as a beauty ideal

Beauty is debatable, but attractiveness is not. A review of 1800 scientific studies shows that there is strong agreement both within and across cultures about who is attractive and who is not (Langlois JH, et al, 2000, Psychol Bull). Facial attractiveness determines not only first impressions of strangers, but also who we talk to, who we get to know, and who we pay attention to. The following features are generally perceived as attractive:

  • Symmetry
  • proportions, which are particularly prevalent among young people, and
  • Proportions that are characteristic of men or women (Perrett D.I., et al., 1988, Nature).

A person's gaze intuitively falls first on the cheekbones when viewing a face from the side or in semi-profile (Saether L., et al., 2009, Vision Res). To enhance the impression of high cheekbones, light-shadow effects are commonly created with makeup. Proportionality often determines whether a facial feature is attractive or not. In symmetry, the cheekbone of one side is set in relation to the other side. A width ratio of the lower jaw in relation to the cheekbone of 75 percent is considered most attractive in women (Wu TY, et al., 2020, J Chin Med Assoc). High cheekbones in relation to the lower half of the face are attractive in both women and men. However, high cheeks have a greater effect on facial attractiveness in women (Woo H.K., 2020, Head Face Med). A ratio of the distance between the cheekbones and the chin and the distance between the corner of the eye and the chin of 80 percent appears attractive (Kaptein Y.E., et al., 2015, Plast Reconstr Surg Glob Open). Based on scientific evidence, aesthetic treatment emphasizes individual features to help the face become more expressive. In the hands of experienced specialists and taking into account harmonious proportions, 94 percent of patients are satisfied with hyaluron injections of the cheekbones (Li D, et al., 2017, Plast Reconstr Surg).

Cheek augmentation for a round face?

Chubby cheeks and a double chin disguise the contours of the cheeks. Beautiful cheeks are created by a gently curved transition from the cheekbones to the lower jaw. The curved contour is best shown off in a half-profile view. The S-curve of youthful high cheeks is known in American parlance as the "ogee curve." There are several approaches to enhance the expressiveness of a round face. Hyaluronic acid treatment can help the side cheekbones and chin look more prominent. Injecting a muscle relaxant into the masseter muscle helps to create a slimmer face. In addition, the eyebrows can be slightly raised with a muscle relaxant. A double chin or sagging cheeks can be corrected with a fat way injection.


How does the face change with age

Age-related changes of the face increase from the age of thirty. Genetic predisposition and lifestyle habits, such as cigarette smoking and frequent sunbathing, can accelerate these processes. Between the ages of twenty-five and forty-five, women experience bone loss, which also affects the cheekbones. The age-related slackening of the connective tissue causes the fat pads of the cheeks to slip. The fatty tissue recedes. The cheeks appear sunken. The facial muscles are stretched and the range of motion of the muscles decreases with age. The changes in the skin cause sagging and wrinkling. All these changes cause the formation of wrinkles between the nose and the corners of the mouth (nasolabial folds) and wrinkles between the corners of the mouth and the lower jaw (marionette lines), as well as dark circles under the eyes. The facial expression may appear tired or sad, although the affected person does not feel tired or sad. The goal of hyaluronic acid treatment is to bring the facial expression back in line with the state of mind. For this purpose, a holistic treatment of the sagging contours is useful.


What is the liquid lift?

Studies show that in old age the deep fat deposits in the face in particular lose volume (Rohrich RJ, et al., 2008, Plast Reconstr Surg.). As a result, the skin and superficial tissues sink. The skin is anchored to facial muscles or bones at certain points and can therefore hardly sink. If the surrounding tissue slackens with age, furrows tend to form at the attachment points. Cheek furrows ("mid-cheek crease") arise on a connective tissue anchorage between the skin and cheekbones ("zygomatic cutaneous ligament"). Dark circles form at the point of attachment of a band between the skin and the edge of the eye socket ("orbicularis retaining ligament", "orbitomalar ligament", "arcus marginalis"). At the nasolabial fold, the skin is connected to several muscles of the mouth. With a hyaluronic acid treatment, the lost volume of the cheeks is replaced. The restoration of volume gives the cheeks more beautiful contours. A precise injection above or below the facial muscles can improve the power transmission of the muscles. The injection restores harmonious, youthful contours and improves the natural expressiveness of the face. The volume build-up creates a certain tightening effect in which the folds between the nostrils and corners of the mouth (nasolabial folds) are softened. The injection of a relatively small amount of hyaluronic acid already leads to a lifting effect with correction of the dark circles and softening of the nasolabial folds and sagging cheeks. The results are immediately visible. However, filler treatments cannot be compared to face lifts. Hyaluronic acid cheek augmentation can significantly rejuvenate the face and delay the need for surgery. A face lift to rejuvenate the lower half of the face is much more effective if the skin is noticeably slack. For a natural and satisfactory liquid lift, the treatment must be appropriate and holistic. Proportionality to other areas of the face such as the temples, forehead or cheek contours should be preserved with the hyaluronic acid injection.


How is the cheeks injected?

Our goal is to underline the facial features that give your face an individual note of beauty or specialty. Characteristics that seem unattractive can be softened by a hyaluronic acid treatment. For a balanced result, your facial contours will be examined and a treatment plan tailored to you will be drawn up. Many patients want an injection immediately after the consultation. After all of your questions have been answered, a numbing cream will first be applied for your comfort. The skin is then thoroughly cleaned with alcohol and disinfected. A concentrated hyaluronic acid is infiltrated near the cheekbones. Slightly smoother fillers are better suited for building up superficial fat deposits. This results in a more harmonious distribution of hyaluronic acid and an improvement in the moisture content and surface structure. The superficial injection stimulates the connective tissue cells (fibroblasts) and increases the formation of elastin and collagen in the tissue. With cooling pads you can prevent swelling or redness immediately after the injection. After the treatment, you will be given a filler pass in which the trade name and batch number of the hyaluronic acid are documented. In order to ensure the best possible result, we will give you a couple of behavioral recommendations. You will be given a number so that you can contact your doctor at any time in case of doubt. We offer our patients an appointment about two weeks after the injection to convince us of their satisfaction.


How much hyaluronic acid for the cheek build-up?

A harmonious and natural result is our priority. The question of how much volume is necessary for the cheek build-up is therefore dependent on the volume that is required so that the cheek, the jaw contour, the lips and the forehead appear balanced and attractive. Always using the same volume in the same place leads to stereotypical faces and does not meet our requirements. The treatment of the cheeks restores the contours that have been lost due to the loss of fat tissue. These changes are age and gender dependent. The amount of product, site and depth of injection must be carefully determined based on an in-depth knowledge of the anatomy. Before each treatment, it is essential to examine the contours and facial expressions. Good cohesion of the gel is important so that the hyaluronic acid does not slip under the influence of the facial muscles. Fillers with a high modulus of elasticity, i.e. slightly firmer gels, are very suitable for filling up the cheekbones. More fluid gels are used for superficial treatment. Depending on the findings, 2 to 4 milliliters of hyaluronic acid are required for 3-dimensional contouring. For an optimal result, it is not only the quantity and quality of hyaluronic acid that is important. Make sure your doctor is experienced in choosing and using treatment techniques.


Author's statement

Author: Stéphane Stahl, MD, PhD. There are no financial relationships with the pharmaceutical or medical device industries that could have influenced the above text. Any reproduction, even partial, is permitted for personal use only. All texts used on this website are protected by copyright.

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