In short. Rebuilding support after too much cheekbone has been removed: what the tissue allows, why it is harder than the first operation, and how it is judged.

Key points

  • The useful question at a revision assessment is not which material would be used.
  • It is what the aim is: restoring support, changing the surface, or correcting a visible hollow in one particular place.
  • Those are three different objectives and they are met differently.

Adding volume back is the revision direction possible after cheekbone reduction, and it is not the reverse of the first operation. Support that was removed can be partly rebuilt and the surface over it can be changed, but the bone that was taken away is not restored.

What rebuilding means here

The aim is to restore support beneath the midface soft tissue and to change how the face reads, rather than to put back the structure that was removed. Volume is added where the deficit is, which may be in the cheek, in the temple or across the midface, and the result is judged on how the whole face looks. It is a different objective from the first operation and is measured differently.

What the tissue allows

The soft tissue over the cheek has been operated on once. Its planes have been altered, some of its attachments have changed, and its capacity to hold what is added depends on how much elasticity and how much substance remain. Where the tissue is thin and has already descended, less can be achieved than in a fuller face, and the assessment is as much about the envelope as about the deficit in the bone.

Ask what the aim is before asking how it is done

The useful question at a revision assessment is not which material would be used. It is what the aim is: restoring support, changing the surface, or correcting a visible hollow in one particular place. Those are three different objectives and they are met differently. A plan that cannot say which of them it is pursuing has not established what the problem is.

Why it is harder than the first operation

Because the anatomy is no longer the anatomy the first plan was made from. The bone has changed, the soft tissue has settled into a new arrangement, and any scarring lies in the planes the revision has to work through. Placing volume accurately in tissue that has already been operated on is less predictable, which is why the limits of what can be achieved are discussed before the operation.

How the decision is made

By waiting until the face has stopped changing, which in practice means somewhere between six and twelve months, and by establishing whether the problem is a loss of support, a change in the surface, or a difference between the two sides. Where the problem is a hollow in one area, the plan is local. Where the whole midface reads flatter than it did, the aim is broader and the result less predictable. Where the tissue will not hold what would be needed, that is said plainly.

Reasons a revision at this site goes wrong

  • Volume is added before the swelling has resolved and the final contour is known.
  • The deficit is treated as a shortage of bone when the soft tissue is what has changed.
  • The aim is not defined, so more is added than the face needed in the first place.

Related reading

Frequently asked questions

Can the cheekbone be rebuilt exactly as it was?

No. What can be done is to add volume back to restore support and improve how the face reads, not to restore the bone that was removed. The tissue that received the first operation has changed, the planes have been altered, and what is added behaves differently from the bone it replaces. It is a reconstruction of an effect rather than a reversal.

What is used to add volume back?

Materials are described here by class rather than by brand: a graft of the patient's own tissue, or an implanted material. Which is appropriate depends on how much volume is needed, on the state of the soft tissue and on whether the aim is to restore support or to change the surface. That is a judgement made at an assessment rather than a choice made in advance.

When can it be done?

Not early. The soft tissue has to have settled and the final contour has to be established before it is clear what needs adding, which in practice means waiting until somewhere between six and twelve months after the first operation. Adding volume to a face that is still changing risks overcorrecting a problem that was resolving on its own.

Risks & Limitations

  • The change to the bone is permanent. Bone that has been cut away cannot be restored as it was, so the amount removed is decided from imaging and treated as fixed once it has been set.
  • The cheekbone is a support. Removing part of it removes part of what holds the midface up, so hollowing in the temple or the cheek is a property of the operation rather than a complication of it, and it is discussed before surgery rather than after it.
  • The zygomatic branch of the facial nerve crosses the region the operation works in. Weakness around the eye or the smile after surgery is usually temporary and usually resolves over weeks to months; a lasting weakness is uncommon but possible.
  • Swelling hides the width for months. The face reads unevenly at two to three weeks, is not close to final until four to six months, and is judged honestly between six and twelve months.
  • Numbness of the cheek and the upper lip is expected after this operation, is watched rather than treated in the early weeks, and may not return fully in some areas.
  • The two sides of a face are rarely identical, and reducing both by the same amount can make a difference that was always present more visible rather than less.
  • The operation changes the width at the level of the eyes and the outline behind the cheek. It does not narrow the lower face, change the bite, lift the soft tissue, or alter the skin.

When to Seek Care

  • Swelling that is increasing rather than settling after the first week, or that is much greater on one side — contact the team.
  • A wound that is opening, or discharge, spreading redness or warmth around an incision.
  • A weakness around the eye or the smile that is worsening rather than improving, or an eye that will not close — seek emergency care at once.
  • Fever, or feeling generally very unwell with a wound or a swollen area.
  • Calf pain, swelling or tenderness in one leg, or shortness of breath or chest pain — seek emergency care at once.

References & Further Reading

  • American Society of Plastic Surgeons (ASPS) — procedure and safety guidance
  • National Institute for Health and Care Excellence (NICE, UK) — relevant guidance
  • Cochrane Library — systematic reviews
  • Chinese Medical Association Plastic Surgery Branch — clinical guidance

Medically reviewed by Tongchun Mao, MD (毛彤春), Deputy Director & Head of Aesthetic Surgery. Last reviewed: 19 September 2026.

This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.