In short. Removing cheekbone support changes the surface above it. Why hollowing happens, who is most at risk, and how a plan anticipates it rather than finding it later.

Key points

  • Before an assessment, look at your own temple in a frontal photograph.
  • If it is already hollow, the cheekbone beside it will read wider than it is, and reducing that cheekbone removes the contrast that was making the face read wide in the first place.
  • That is a face in which adding volume above may answer the complaint better than removing bone below.

Hollowing after cheekbone reduction is not a complication in the sense of something that went wrong. It is the other side of what the operation does. The cheekbone is a support, and the soft tissue of the midface rests on it, so removing part of the bone changes the surface above it as well as the contour beneath.

Why it happens

The midface soft tissue is not fixed to the bone along its whole length. It is supported by it, and the cheekbone is the main buttress of that support. When the prominence of the bone is reduced, the tissue that was draped over it has less to rest on and settles differently. The result is a change in how light falls across the cheek and the temple, which reads as hollowing.

Where it shows

In two places more than others. In the temple, above and behind the outer corner of the eye, where a hollow that was slight before the operation can become obvious. And in the cheek itself, below the outer corner of the eye, where a loss of projection makes the face read flatter and, in some patients, older. Both become visible at around two to three months, once the swelling has fallen enough for the contour to be read.

Look at the temple before you look at the cheekbone

Before an assessment, look at your own temple in a frontal photograph. If it is already hollow, the cheekbone beside it will read wider than it is, and reducing that cheekbone removes the contrast that was making the face read wide in the first place. That is a face in which adding volume above may answer the complaint better than removing bone below.

Who is at risk

A face with thin soft tissue over the cheekbone is at more risk than a fuller one, because there is less tissue to redrape and less volume to hide the change. An older face is at more risk because the tissue has already begun to descend. And a face in which the temple is already hollow is at the most risk, because the reduction removes the structure that was compensating for it.

How a plan anticipates it

By assessing the soft tissue as carefully as the bone, and by treating the amount of reduction as something to be limited rather than maximised. Where hollowing is judged likely, the plan may reduce less, may change which structure is addressed, or may discuss adding volume at the same time as the reduction or after it. What no plan can do is remove a support and leave the surface over it exactly as it was.

What to establish before the operation

  • How much soft tissue there is over the cheekbone, and how the change is likely to read.
  • Whether the temple is already hollow, and whether that is making the cheekbone look wider.
  • How much reduction is planned, and what would be done if hollowing proved too marked.

Related reading

Frequently asked questions

Why does the face look hollow after the cheekbone is reduced?

Because the cheekbone is a support rather than only a shape. The soft tissue of the midface rests on it, and when part of the bone is removed that tissue has less to rest on. The surface above the bone therefore changes as well as the bone itself, and in the temple and the cheek that change reads as hollowing or as a flatter midface.

Who is most likely to hollow afterwards?

A face that already has little soft tissue over the cheekbone, an older face where the tissue has begun to descend, and a face in which the temple is already hollow before anything is done. In those faces a reduction that would read as a modest change in a fuller face can read as a marked one, which is why the assessment looks at the soft tissue and not only at the bone.

Can hollowing be corrected afterwards?

It can be addressed by adding volume back rather than by restoring the bone, and that is the commoner revision direction. It is a different operation from the first, it works with the tissue that is there rather than replacing what was removed, and the result is judged on how the face reads rather than on how much bone has been restored.

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.