Fillers Don't Seem to Work to Volumize my Face?

forgot to add ... : Sculptra has a track record of forming "granules" (or whatever they're called) that are sometimes visible on the surface but always felt underneath the skin. It's part of the body's response against them (as best as I understand it). From what other doctors have told me, all the dilution and massaging in the world will not prevent them from occurring if that is what one's immune system is going to do. There's no way to predict in advance.

A dermotologist examined me and told me (perhaps somewhat facetiously) that he could inject Juvederm in me once-a-month for 2 years and it still wouldn't volumize me out to what I desired. He said that there are few doctors who specialize in such "massive volumization" and was trying to remember the name of one in Canada.

Again, the area of concern is the hollow part of my cheeks and not above where the eye socket bone starts. Touch your finger on the bottom of the upper row of teeth and that pinpoints the NL fold area. If I knew I only had 5 years to live, I'd go to Mexico and have silicone injected. By the time it migrates and lumps, I would be dead.

The doctor who told me that he couldn't fill out my cheeks and to "eat more" said that fillers and fat transfer certainly have their place but not for what I was seeking. But I'm not a fan of the buzzphrase "reasonable expectations" (perhaps due to my engineering background) and rather adhere to StarTrek's Capt. Kirk's "I don't believe in no-win scenarios". But in all fairness, perhaps medical science hasn't advanced far enough in this area.

Update/More Info: immediately after the 3 vials of Radiesse were injected into the malar area, that portion swelled up (too much IMO). More from the reaction of the deep insertion than from the Radiesse, I suspect, because 3 days later the swelling subsided and no enhancement was visible. 2 weeks later the doctor said that he could still "feel" the Radiesse in spite of not seeing any results.

But where I really needed it all along was in the NL fold area (what I call "cheeks"; i.e., what lies below the submalar region). The doctor now wants to extract fat from behind the inside of my knees to fill that area. Implants cannot be put in that region (there are no bones to anchor it). Plus implants bring with them long-term problems. Additionally I feel that because my skin is so thin at my age, you could see the outline of any implants and would have to use fillers to conceal that (thus defeating the purpose of using implants to get away from fillers).

These concerns were readily seen by the PS who did my facelifts. He has always been VERY conservative and tries to keep things simple. He did suggest laser resurfacing to "smooth" the facelift but added that it would not "plump" me out. The only laser he recommends is the fully ablative CO2. Any of the newer fraxel types would be a waste of money in my case (the minimal results would vanish when my healing was complete). But because he could not guarantee that I would not be "pink" for the rest of my life (I'm red-haired, fair thin skin, sunburn easy), I've not followed through with that. (I still sport a small burn on my forehead from a 50% AHA peel 12 years ago!) He said that treatments like Thermage sound good in theory but they don't work for most people.

I never had that much facial fat as a teenager let alone now. So maybe I'm a lost cause as far as that goes. If I eat more, I gain it around my waist before the face and I don't want that. Indeed, the "love handles" around my waist are loose skin and not fat (I've already asked about liposuction; exercise does not help). I actually would like to lose 5-10 more pounds (to 115-120) for some personal reasons (I'm competing against much younger people in this area).