Q: What are the pros and cons?

Pros Cheek fillers can restore lost facial volume, create more fullness, or sculpt and define the cheekbones. If you want cheek augmentation but aren’t yet ready to commit to implants, cheek fillers offer a less expensive, temporary alternative that allows you to "try on" the look for a few years. You’ll see an improvement in contour or fullness immediately after your treatment. When the treatment is performed by an experienced injector, side effects and risks are minimal (compared to cheek implant surgery). A suboptimal result from hyaluronic acid fillers can be reversed with hyaluronidase , an enzyme that breaks down HA. Cons Cheek filler results aren’t permanent. The HA most commonly used for the treatment are naturally metabolized within one to two years (some patients metabolize fillers more quickly than others). This is a very technique-sensitive cosmetic procedure, and it does come with risks; more on that below. Keeping up your results over time can get pricey. Related: Cheek Implants Are Trending. Here’s When to Get Them Instead of Filler.

Question 1

What are cheek fillers?

Accepted Answer

Cheek fillers are an injectable treatment that uses FDA-approved dermal fillers to sculpt and define to the upper arch of the cheekbone, or to add subtle volume to the midface.

Unlike cheek implants, a plastic surgery procedure that offers permanent results, cheek fillers are a temporary, minimally invasive option for cheek augmentation and contouring.

The most commonly used facial fillers are hyaluronic acid-based. This substance is naturally found in our bodies, and it’s a powerful humectant: a single hyaluronic acid (HA) molecule can attract and hold up to 1,000 times its weight in water.

Juvéderm and Restylane are the most popular hyaluronic acid fillers, though a growing number of providers offer Revance’s RHA Collection. Each brand has a range of formulas that vary in viscosity, with the thickest and densest—Restylane Lyft, RHA 4, and Juvéderm Voluma—typically used to define the cheekbones, chin, or jawline.

Other types of dermal fillers used in the midface include:

Radiesse, a calcium hydroxylapatite-basedfiller that typically lasts up to a year.
Sculptra Aesthetic, a synthetic poly-L-lactic acid filler that promotes new collagen production for two to three years.
Bellafill, a combination of polymethyl methacrylate (PMMA) microspheres suspended within a base of smooth collagen gel. Results typically last up to five years.

If you’re concerned about a synthetic substance in your face, you do have other options. “Natural fillers have become increasingly popular,” according to Dr. Mark Berkowitz, a board-certified oculoplastic surgeon in Sterling Heights, Michigan. “Your own blood can be used to form a filler with EZ gel and Cellenis Derma PRP,” notes Dr. Berkowitz. “Body fat transfers can also be utilized to enhance the cheeks.” Fat transfer involves harvesting excess fat from other body areas via liposuction, refining it, and injecting it into the face. This procedure is more expensive than temporary dermal fillers, but the results are much more long-lasting. Just be aware that fat adds volume, but it lacks the density to create the kind of cheekbone definition that fillers like Juvéderm Voluma or Restylane Lyft can achieve.

RealSelf Tip: It takes an artistic eye to create natural-looking, aesthetically pleasing cheek filler results. Some injectors take a one-size-fits-all approach, while the most talented ones customize their approach for each patient’s anatomy and aesthetic goals. Those who get a more bespoke cheek filler treatment tend to be happier with their results, so never discount the importance of carefully selecting your provider—not just booking with the one who offers the lowest price. “Sometimes picking the lowest price costs you more in the long run,” Dr. Berkowitz cautions.

Question 2

What are the pros and cons?

Accepted Answer

Pros

Cheek fillers can restore lost facial volume, create more fullness, or sculpt and define the cheekbones.
If you want cheek augmentation but aren’t yet ready to commit to implants, cheek fillers offer a less expensive, temporary alternative that allows you to "try on" the look for a few years.
You’ll see an improvement in contour or fullness immediately after your treatment.
When the treatment is performed by an experienced injector, side effects and risks are minimal (compared to cheek implant surgery).
A suboptimal result from hyaluronic acid fillers can be reversed with hyaluronidase, an enzyme that breaks down HA.

Cons

Cheek filler results aren’t permanent. The HA most commonly used for the treatment are naturally metabolized within one to two years (some patients metabolize fillers more quickly than others).
This is a very technique-sensitive cosmetic procedure, and it does come with risks; more on that below.
Keeping up your results over time can get pricey.

Related: Cheek Implants Are Trending. Here’s When to Get Them Instead of Filler.

Question 3

How much do cheek fillers cost?

Accepted Answer

Your cheek filler cost will depend on the credentials of your injector, their practice location, the type of filler they use, and how many syringes they use to achieve your desired result.

Asking for a total cost estimate during your consultation can help you avoid a surprise when you get your bill.

Most providers offer payment plans or accept third-party financing options, such as CareCredit.

Question 4

Cheek fillers before and after photos

Accepted Answer

The cheek filler photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 5

What do cheek fillers do?

Accepted Answer

Cheek fillers can do several things. Depending on the patient’s aesthetic goals, they can:

Temporarily add plumpness to sagging cheeks, reversing the volume loss that usually comes with aging or prolonged illness.
Enhance your natural cheekbone structure.
Create a smoother, younger-looking foundation for the lower eyelids. “Improving cheek contours can help rejuvenate the lower eyelids, especially the ‘tear trough’ area,” Dr. Berkowitz explains.
Make the entire face look more balanced, especially for patients who have a naturally wide mouth or jaw.
Smooth nasolabial folds (the smile lines that extend from the nose to the mouth), as well as marionette lines.

Fillers also stimulate natural collagen production. Once injected, they can rev up your fibroblasts, your body’s collagen-making cells, meaning that less filler may be needed to achieve similar results in the future.

While no nonsurgical treatment can deliver the same transformation as a facelift, many providers say cheek fillers can provide a subtle lift. Dr. Berkowitz says that this lifting effect can improve jowling for many patients.

Related: Can Cheek Fillers Really Lift the Face? Experts Weigh In on What to Expect

Question 6

How is a cheek filler procedure performed?

Accepted Answer

Here’s what to expect during your cheek filler appointment:

You’ll start with a consultation with your injector, to discuss your goals and treatment plan.
They will recommend the best filler formula for you, as well as the best placement to help you achieve your desired look.
They should also note how many syringes they plan to use and how that will impact your cost.
Your provider may apply numbing cream about 30 minutes before your injections, to help reduce sensation. At many practices, you’ll also be offered Pro-Nox, to help keep you comfortable.
As a final bit of prep, your skin in the treatment area will be thoroughly cleansed.
The treatment itself is quick: they will inject the filler directly over the cheekbones or into the hollows of your cheeks, taking care to create a symmetrical result.
As they inject, they’ll lightly massage the filler to help smooth it out.
Once you’re done, your provider may give you a small ice pack to help soothe any lingering discomfort or swelling.

RealSelf Tip: For more complete facial rejuvenation, your provider may recommend complementary treatments, like Botox, a PDO thread lift, or chin filler. You may even find that they offer a small discount on any additional treatments performed at the same time.

Question 7

Do cheek fillers hurt?

Accepted Answer

Getting cheek fillers can be uncomfortable, but it isn’t painful for most people, especially compared to injections in more sensitive areas like the lips.

Many providers apply a topical numbing cream to the injection sites about 30 minutes prior to treatment, which can dramatically reduce the sensation of the injection. “Pro-Nox (nitrous oxide) is utilized in many offices to take the edge off,” notes Dr. Berkowitz.

Most filler formulas—including the entire line of Juvéderm, Restylane, and RHA Collection fillers—also contain the pain-relieving local anesthetic lidocaine. That built-in anesthetic, paired with the numbing cream, means you’ll likely just feel the pressure of the filler as it’s injected under your skin.

Afterwards, you may be given a small, light ice pack to help reduce discomfort and minimize swelling.

Question 8

How long does recovery take?

Accepted Answer

Most people need little to no recovery time after this treatment, but you may choose to take some social downtime. Some people schedule their appointment on a Friday afternoon, in case they experience bruising or noticeable swelling before having to head back to work the following week.

If you’re alarmed by your appearance immediately after your cheek filler treatment, be patient: the worst of the swelling should resolve within 48 hours, as the cheek filler begins to settle into your natural tissue. Any remaining swelling should resolve within two weeks.

To help reduce your likelihood of bruising and swelling:

Avoid drinking alcohol or taking any blood thinners or ibuprofen in the days leading up to your cheek filler injection and sleep elevated for the few evenings after your treatment.
Talk to your primary healthcare provider about your regular prescriptions and supplements; certain medications can increase your odds of bruising.
Skip strenuous exercise for the first 48 hours post-treatment, to avoid additional swelling and prevent the filler from possibly migrating.
Avoid sleeping on your face for the first few days post-treatment.

Related: Why You Get Swelling After Lip & Cheek Fillers—and How to Reduce It

Question 9

How long do cheek fillers take to settle?

Accepted Answer

It takes up to two weeks for cheek fillers to fully settle and swelling to resolve, so you can see your cheeks’ new contour and volume.

So while you'll see an enhancement in your cheek area immediately post-treatment, don’t worry if your initial results aren’t what you expected: they should improve in the coming days and weeks.

Question 10

How long do cheek fillers last?

Accepted Answer

How long your cheek fillers last will depend on which formula is used and how your body metabolizes it.

HA-based fillers last one to two years.
Radiesse results last up to one year.
Sculptra results last two to three years.
Bellafill can last five years or more.
Fat grafting results can last for decades.

Question 11

What are the risks and side effects of cheek fillers?

Accepted Answer

Cheek fillers are widely considered to be safe in experienced hands, but they're not risk-free.

The most common side effects are the same ones you can expect with all facial filler treatments: bruising, swelling, and redness at the injection site. These side effects usually disappear on their own within a few days of your treatment, though it can take up to two weeks for all swelling to resolve.
Allergic reactions are very rare with HA fillers, but they are possible.
There’s a small risk of infection at the injection sites. Removing all makeup prior to your treatment and not applying it in the treatment area for at least the first 12 hours post-treatment can help reduce the chance of infection.
An even more rare but potentially serious risk is tissue necrosis, which can occur if your injector accidentally injects the filler into a blood vessel, a complication called vascular occlusion. The risk of this complication increases significantly if you choose an unqualified injector who doesn’t have a full understanding of the underlying facial anatomy. Again, opting for an experienced, well-trained provider with a solid track record of glowing patient reviews can help mitigate this risk. Choosing an HA filler that can be dissolved in the event of a complication also gives you another layer of safety.

The safety of dermal fillers during pregnancy or while breastfeeding has not been studied.

Talk with your provider if you have any concerns about the safety of this treatment.

CHEEK FILLERS

Dr. Mark Berkowitz

Emily Orofino

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Dr. Mark Berkowitz

Emily Orofino

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