Cheek Filler
As we age one of the effects is the downward sag of the midface. This results in the lateral extension of the tear trough until it effectively turns the youthful curve of the cheek into two curves, the lower of these curves extends into the nasolabial lines and into the jowl on the jawline. A facelift is an effective approach to the jowl, but doesn't replace the missing volume. A better solution is therefore to replace the missing volume, hence the popularity of deep cheek filler.
This is particularly effective on its own in your 40s and 50s, and can be added to a facelift in your late 50s and 60s. I use the more viscous long acting hyaluranic fillers as they are effective, reasonably long lasting and crucially reversible. The technique is shown below. There has been debate as to how much filler is required. I like the less is more approach, and will put as little as 0.6ml in each side in the first instance, especially in a younger patient. If your cheeks are flat then you will normally need a syringe each side.
If you are considering tear trough filler always appraise your cheeks first, as cheek filler is a more effective approach to the lower part of the tear trough. I recomend doing the cheeks first, as you can then better judge how much filler you need for the tear trough.