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Non-surgical Way to Restore Volume in Midface?

Having had Juvederm injections several times for smile lines before, one doctor said that she could inject it in my cheeks and under my eyes if I want to try to restore some volume. I am hesitant because my experience is that the product stays where it's injected, what would be my options? What is the best and most natural non-surgical way to restore volume in the cheeks and under eyes that won't give me a lumpy result?

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16 Doctor Answers | Asked by busyindc in winston-salem, nc

Doctor Answers (16)
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Juvederm and Restylane as non surgical alternatives

Juvederm and Restylane are wonderful non surgical alternatives to volumizing the face. I also use Radiesse as a mid face filler. I do not recommend it under the eyes. If you have a small amount of fat that could be removed I also recommend fat transfer as a great alternative to all of these. You stated non surgical in your question however with a small syringe we are able to remove fat from an area via syringe and then purify that fat and reinject that fat into the areas that need... more

Michael Elam, MD

83 reviews

Orange County Facial Plastic Surgeon

michaelelammd.com

Fillers are often used to improve fine lines and volume to the face

Fillers are a non-surgical way to add volume to the face. As we age we lose fat and bone volume in our face. If you look at pictures of actors as they age you we see a thinning of the face with age. This is a natural progression. On the lower eyelids we develop a depression under our eyes which occurs due to the descent of the cheek tissue. Restalyne and juvaderm are the fillers of choice for the lower lids because this is a tricky area to fill. If the area is over-corrected it... more

Juvaderm Ultra Plus works for midface volume restoration

Juvaderm Ultra Plus works well to restore volume in the midface. It can last 6 to 12 months. I also use Radiasse as a midface filler. This lasts a bit longer. Costs are equivilent with 0.8 cc syringes about $650. Fillers beneath the thin skin of the nasojugal groove and perioribital skin require a thinner hyuronidase product, such as Restylane or Juvaderm Ultra. These cost $600 per syringe.

Fillers for the midface

Fillers are the best treatment. Juvederm or other fillers work best when injected below the muscle under the eyelid area to minimize bruising and create a more smooth result. The fillers are used in the deep plane in the cheek with multiple passes and small amounts per pass to spread out the product so there is only a small chance of lumpiness. The hyaluronic acid fillers such as Juvederm and Restylane / Perlane can be treated with hyaluronidase to thin out the lumpiness should it occur.... more

Fat injections and other dermal fillers

Volumizing for the midface is one of the best ways to rejuvenate this area. Dermal fillers and fat transferring procedures can markedly bring youth to this area in a natural way. Dermal fillers are a non surgical way to do this without long incisions but the effect is short lived lasting from 6 months to a year or more depending on the product. Fat injections are another option that also requires no incisions just small puncture holes to achieve beautiful results that can last years up to... more

Philip Young, MD

6 reviews

Bellevue Facial Plastic Surgeon

The most natural way to restore volume is by injection of fillers

Fillers have become gold standard for volumizing the cheeks. In my experience, Sculptra and Radiesse work wonderful in this area. For under eyes, however, Hyaluronic acid based fillers such as Restylane and Juvederm work better and are safer.

Nissan Pilest, MD

4 reviews

Irvine Dermatologic Surgeon

Midface fillers

I agree with the others. Fillers are the best option for treatment. However, some fillers are better than others. Scuptra in my opinion is not a good choice if you are using it close to the thin skin of the lower eyelid. The hyaluronic acid fillers are great... Restylane probably being my choice. The injections should be done by an experienced physician. The fillers should also be placed as deep to the skin as possible to avoid lumpiness. Volume is what you are trying to acheive.... not r more

Mid-face Non-surgical Rejuvenation

Hi Newmie, Juvederm is excellent for restoring volume in the midface. I would use Restylane close to the eyes as sometimes Juvederm swells a little too much in this area leading to unsatisfactory results. Another non-surgical method of restoring midface volume and lifting the slight laxity of the area is treatment with fractionated carbon dioxide laser. I have been using Fraxel re:pair for the past year. One of the most consistent effects is a slight lift of the mid-face, and smoothing of... more

Michael A. Persky, MD

21 reviews

Los Angeles Facial Plastic Surgeon

drpersky.com

Midface rejuvenation

Sculptra is an excellent product to provide mid-face rejuvenation. It requires several treatments but can add fill. Products like Hyaluronic acids are better for lines int he face and maybe better around the eyes.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

It's not the filler, it's the Filler

There are many ways to improve mid-face atropy. I regularly use Radiesse, Sculptra, and all the HA fillers. It is more important to discuss your options with your dermatologist or plastic surgeon and go with the filler that they like best for your presentation, age, skin type, etc. I do, however, like Restylane best closer to the eyes. This is, of course, my preference, and your doctor may have a different opinion. That is why the Filler (the doctor) is the most important choice, not the... more

Cheek enhancement

Fillers work well for mid face enhancement, particularly the ones that are thicker and give more "plump", e.g. Perlane, Juvederm Ultra Plus, Radiesse. I also like fat transfer for this area for the same reason. The advantages of fat transfer are that it is very natural and the results can be permanent. A certain percentage of fat survive with each transfer. In contrast, for infraorbital filling, I prefer fillers that do not give as much "plump", since the lower... more

Juvederm and Restylane are excellent for this

Volume enhancement in the cheeks and lower lids can very nicely be done with HA products. These make a nice addition to the area but need to be done by an experienced and skilled injector. They also last longer than around the mouth because of their being less motion in this area. Fat injections have fallen into less favor because of variable survival of the fat and the need to harvest it surgically.

Mid face volume restoration with fillers

Juvederm, a hyaluroic acid filler, like Restylane is an excellent choice for midface volume correction. Alternative choices include Radiesse and Scultra, though both are different in structure and onset of results. Post injection message in that area by the injector, helps to prevent lumps, and overcorrection is to be avoided.

Stick with what works for augmentation of cheek or face

You seem to have been happy with Juvederm, so I would recommend that you stick with it for augmentation of the cheek/face area. There are a variety of off the shelf products but the beauty of these is that it avoids the downtime of a surgical procedure, such as cheek implants for example. The limiting factor is that they are not permanent. see video

Volume for the mid-face

Dr. Placik gives a nice summary of your options for volume restoration of the cheeks. For the lower eyelid area, my preference would be Restylane over Juvederm, but either Juvederm Ultra Plus, Perlane or Radiesse are great options for cheek augmentation. Good luck.

Options for cheek fillers

I don't quite understand you hesitation if you have had a favorable experience with the Juvederm. Essentially Juvederm comes in two forms Ultra and Ultra Plus. The latter is usually preferred for deeper (cheek) augmentation. Alternatively, you could consider Restylane and Perlane. The latter is comparable to Ultra Plus. Other cheek fillers include Sculptra or Radiesse. Lastly, the use of autologous fat injections is an option but does involve minor surgery.