This article has been medically reviewed for accuracy by New York board-certified dermatologist, Dr. Michele Green on November 5, 2020.
It’s a common scenario: Your injector asks what’s bothering you. You say your nasolabial folds and burgeoning jowls make you look old. And then your injector promptly fills your cheeks with hyaluronic acid.
For years, it’s been widely accepted that this midface volume boost can bring with it the added benefit of lifting. But more recently, the question of whether cheek filler can actually lift the lower face to smooth smile lines and reduce jowling has become a source of debate among injectors.
“The idea that fillers can lift comes from the fact that cheek fillers, when done well, do indeed provide a beautiful rejuvenation effect,” explains Dr. Christian Subbio, a board-certified plastic surgeon in Philadelphia. “But many injectors and patients confusingly label this result lifting, when in reality all that has happened is filling or reinflation.”
Still, some experts say otherwise—that injecting filler along the cheekbone can actually lift up the lower half of the face, even if only subtly. “It is possible for cheek filler to provide lift for the lower half of the face,” says Dr. Marisa Garshick, a board-certified dermatologist in New York City. “Cheek filler can be used in the patient who is starting to notice a slight drop, even at an early age, as filler along the cheekbones can be helpful to keep things in place and prevent further drooping.”
So what can patients actually expect? Experts on both sides of the argument weigh in.
Some say the “lift” cheek fillers provide is all an illusion.
“If you inject enough filler [into the cheek area], it can give the illusion of lifting because it stretches the skin out,” explains Dr. Rod Rohrich, a board-certified plastic surgeon in Dallas. “But it cannot truly lift—that is kind of a misnomer.”
Filler can contour specific areas of the face (or body) in order to fine-tune certain features, adding volume where it has otherwise been lost or never naturally existed in order to achieve a more symmetrical or youthful-looking appearance. Wherever it is placed, filler will plump—the overlying skin experiences a swelling effect. However, according to some experts, this plumping does not actually lift anything.
When asked to explain why fillers can’t deliver some degree of lift, Dr. Subbio responds, “The better question is, why would a small blob of clear jelly lift a face? As a surgeon who has performed many facelifts, I can tell you that even with a scalpel and sutures, it is difficult to achieve an actual lift. That’s because the heaps of facial tissue are heavy and fused into their position with ligaments large and small.”
To support his position, he cites a published study by Dr. Val Lambros, a board-certified plastic surgeon in Corona del Mar, California.
In the study, Dr. Lambros examined the effect of cheek fillers on the nasolabial fold using a three-dimensional camera. More specifically, he sought to find out whether “adding volume to the cheeks creates a pulling force on the skin that elevates the nasolabial crease or nasolabial fold like fingers will do when simulating a vertical pull in a mirror.”
He found that filler expanded the skin where it was injected but did not lift or have any real effect on the nasolabial folds. More important, however, this filler-induced expansion did lead to a “perceived improvement of the nasolabial fold.”
“Filler can offer a slight volumetric lift, just like filling a balloon causes it to rise,” explains Dr. Jennifer Levine, a board-certified facial plastic surgeon in New York City. “So by increasing the volume in the midface, it makes the lower face look better.”
By imparting volume to the midface, cheek filler creates definition and symmetry—which, in turn, results in the appearance of a more lifted look. “When the cheek looks more angular, it looks like it’s lifted, [but that’s] kind of an illusion,” Dr. Rohrich explains. The bottom line, he adds, is that “you cannot truly lift the face or the cheek with a filler, you can [only] volumize it.”
Related: The Surprising Reason I Tried Cheek Fillers for the First Time
Others say that the lifting power of cheek filler is real, though subtle.
“Cheek filler injected in the upper half of the face can subtly lift age-related changes experienced by the lower half of the face,” says Dr. Kay Durairaj, a board-certified otolaryngologist in Pasadena, California. “By contouring the cheekbones using filler, the lower half of the face is tightened and lifted upward, which reduces the appearance of nasal folds, sagging skin, and marionette lines.”
Dr. Durairaj points to another study, published in the Journal of Cosmetic Dermatology, which examines how specific injection points can affect the outcome of cheek filler. Without getting into the nitty-gritty scientific terminology, the results of the study “emphasize the importance of respecting the layered arrangement of the facial soft tissues when performing minimally invasive soft-tissue filler injections.”
In other words, injecting at very specific points and depths in the facial tissue can increase the volumizing effect of filler.
“When trying to achieve lift, filler is placed deep [toward] the bone, to create support for the overlying skin, so it is thought to provide lift to anything that is sitting above the bone,” Dr. Garshick explains.
Of course, there’s a big difference between filler merely elevating the skin directly over an injection point—adding a fraction of height locally by serving as padding—and filler in one part of the face (the cheeks) exerting an actual upward pull in order to hike up a completely separate part of the face (the nasolabial folds or jowls).
The bottom line?
Speak with your provider before they pick up a needle, to set reasonable expectations. The volumizing effect of cheek filler may be able to help create a subtle, localized lift, but only if injected at the proper points and depths. Filler, however, does not structurally lift underlying facial tissue.
“Fillers in the lower face, in the right patient and right amount, can actually do a good job of masking the effects of aging,” Dr. Subbio says, “but it is not actually lifting, [and] this distinction is important.”
If improved symmetry, definition, or volume restoration in the cheeks and midface is your goal, then filler can help. On the flip side, if smoother nasolabial folds and a tighter jawline are what you’re after, then a syringe of two of cheek filler may leave you feeling disappointed.“
It is important to know that [cheek filler] is not going to provide the same results as a surgical facelift, particularly for someone with extensive sagging,” Dr. Garshick explains. “The beauty of cheek filler is that it can naturally enhance the appearance of the cheekbone, provide contour, and help restore volume that gets lost over time.”
