I have a wrinkle line that starts from the inside corner of my eye that goes down and across the cheekbone area. I've attached a photo I found online that best shows what I'm describing. A dermatologist recommended using fillers after doing subcision(?) in that area. The results were great from the reviews and pictures I've seen. Second consult was with a plastic surgeon who recommended getting fat transfer there. Which would be best for the wrinkle line across the cheeckbone?
Which is Better, Fillers or Fat Transfers for Cheek Wrinkle Line?
Doctor Answers (6)
Fat vs Fillers
This is a question I hear often in my practice. As a general rule of thumb, I prefer to use injectable fillers because they are predictable in terms of duration and placement. In addition, there is no need to harvest your own fat and you can fill the area gradually- over time- for a softer, more natural look. Best of luck, Dr. Clevens
Web reference: http://www.drclevens.com/sculptra.htm
Fillers vs. fat for cheek wrinkle.
Excellent question. If it were me I would have Juvederm or Radiesse rather than fat. These can be precisely placed and though they last 1-5 years, they sre very "forgiving".
Fat Transfer or Filler for Filling-in Cheek Wrinkle?
For this area, I would recommend Restylane® because it’s not quite as thick as Perlane® or Juvéderm®, and you’re not likely to get the swelling in this area that you could see with Juvéderm. It will give you a great lifting effect. Fat transfers can be good, but they are unpredictable. For transfers, I usually recommend a series of three sessions to compensate for any resorption of the fat or asymmetry. However, with the variety of predictable fillers available today, I am doing fewer fat transfers and the fillers are smoother.
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Restylane and juvederm vs. fat injections for the tear trough
I prefer the hyaluronic acids when I inject underneath the muscle in the tear trough as fat is more unpredictable, can be lumpier than the hyaluronic acids, fat is more viscous or thick and not as safe as Restylane in this area, and if there is an overcorrection, hyaluronidase can be injected to dissolve the Restylane or Juvederm but there is no similar treatment for overcorrected fat areas.
Web reference: http://www.thenyac.com/restylane/index.html
Fillers Are Predictable and Don't Require a Donor Site
My answer directly mirrors that posted by Dr. Clevens. Fillers are readily available, predictable, don't require a donor site, and do not carry the expansion/ contraction properties that fat cells do.
Fat grafting versus filler injection for cheek filler
Either approach is reasonable. The filler injection in the office has the benefit that it is temporary in case you don't like the result. You could then do fat grafting subsequently if you do like the look in order to get a more durable result. Fat take is variable when doing fat transfer, but this modality can give quite a bit of improvement in situations like yours.
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