Cheek Enhancement: The Next Frontier


During professional and social interactions we all make judgments about the health, vitality, and beauty of those we meet. When observing a face, the most obvious hallmark of youth is full cheeks (malar eminences). A youthful face is characterized by a balanced distribution of superficial and deep fat, which results in a three dimensional series of arcs and convexities, supported by the underlying bony skeleton.

In a youthful face, the transition from the cheek to the lower eyelid is a subtle lid-cheek interface which is barely distinguishable. It is where the cheek ends and the eyelid begins. Likewise, the transition from the cheek to the facial tissue below (submalar area) is an equally subtle transition.

With aging however, all this changes. The soft tissues of the mid-face descend, the lid-cheek interface becomes more apparent with the appearance of a longer, lower eyelid that is punctuated by a prominent depression, the tear trough. Additionally, puffiness of the lower eyelid, prominence of the bony orbit, loss of cheek prominence, a hollow submalar area below the cheek bone and the development of prominent laugh lines (nasolabial fold-lines that run from the mouth to the nose) collectively contribute to a tired appearance. These changes are accentuated by loss of skin elasticity and bone in the underlying facial skeleton. It is primarily the loss of facial fullness and re-distribution of facial fat that provides visual clues to a person's advancing age.

Fortunately, there is a myriad of options that can enhance cheeks and restore the malar area to a youthful appearance. There are several non-surgical procedures that are less invasive and less expensive (but not permanent), as alternatives to surgery. The primary goal of facial rejuvenation is to restore the face to a healthy, vibrant, youthful and energized appearance. This can be achieved with a variety of "fillers", as well as the transfer of fat, which is harvested from any body area that has a little fat to spare.

Fat transfer, is a well-established, safe, and natural way to restore youthful facial contours. This technique is advantageous, because most patients have an abundance of this natural resource! Using the patient's own tissue eliminates the possibility of an adverse reaction. Though the fat deposits gradually dissipate, retained portions may last for many years. Fat is an excellent choice for enhancement of the cheeks, softening of the lid-cheek interface, or the correction of facial hollows or concavities. The procedure is usually performed under local anesthesia and patients usually return to work within a week.

Synthetic fillers can also be used to rejuvenate the malar, submalar area and lower eyelid-cheek interface. Synthetic fillers include Restylane, Perlane, Juvederm, Radiesse, Sculptra, and Evolence. Depending on the filler and the area treated, the results can last up to 2 years. As opposed to fat, "fillers" have a greater ease of application, require no recovery and give an immediate instantaneous result.

Article by
New York Dermatologic Surgeon