What Are The Risks That Come Along With Cheek Fillers, Is It Something I Have To Commit To Once I Start?

Question

1)Once I start fillers, am I stuck for life - will my cheeks look worst than before if I suddenly stop them? 2)Which filler works best on men? 3)Do fillers look completely natural - will anyone be able to tell? 4)Is cheeks a risky area for fillers? 5)Is it possible to do bit at a time (so 1ml now, then another 1ml in a month - incase I hate 1st results)? 6)I would like the filler to make me look <25 (I don't have wrinkles).. is this a realistic aim? 7)How to find good surgeon in my area?

Michael Law, MD · Answer

A wide variety of facial implants are currently available for the enhancement of the skeletal elements of facial aesthetics. The most commonly used facial implants are used to enhance the profile of the chin and the cheeks. Facial implants very widely not only in shape and style, but also in terms of the materials from which they are fabricated.

	My preference is to use structural fat grafting, as much as possible, to enhance facial features. In many cases, the need for a solid implant can be eliminated by the careful and meticulous grafting of a patient's own fat. While the incidence of complications with facial implants is not high, certain problems may develop which require implant removal including infection and implant migration. Bone resorption (bone loss) has also been reported below solid facial implants. Neither of these problems are an issue with structural fat grafting.

	The only setting in which I currently use a solid facial implant is for chin implant augmentation. Some patients with a 'weak' chin profile can be adequately improved by structural fat grafting alone. However, when the chin protrusion needs to be enhanced by a half centimeter or more, a chin implant is absolutely required. I prefer to use a soft, flexible, anatomic chin implant that conservatively enhances the anterior projection of the chin in profile. The chin implant is placed through an incision hidden underneath the chin, an area where many people already have a scar from a fall in childhood.

	Moderate enhancement of chin projection in appropriate patients can dramatically enhance the profile, in a manner that is completely natural-appearing. It is remarkable how increasing chin prominence in some patients will reduce the apparent prominence of the nose, and restore an overall sense of harmony and balance to facial features.

	For enhancement of the cheek bone area, I rely exclusively on structural fat grafting. Careful and meticulous fat grafting not only avoids some of the potential complications of solid cheek implants, but it also allows more precise 'customization' of the aesthetic improvement that can be obtained for each individual patient. It is also my opinion that structural fat grafting produces a more natural-appearing enhancement of the cheek area than what is generally achieved through the placement of solid implants over the cheekbone.

Sutton Graham II, MD · Answer

Injectable fillers are an excellent alternative to surgical cheek implants - and are used much, much more commonly for cheek enhancement.

	Fillers are generally FDA approved for only the nasolabial groove, but frequently used for other purposes (so called "off-label" use).  When used by experienced physicians, they appear to be safe and effective, although possible risks should be discussed beforehand.  The reversible nature of these treatments means you will need future treatments to maintain your results, but have the advantage of gradual evolution of desired changes (as you suggest).  Hyaluronic acid (HA) fillers have the additional advantage of the possibility of enzyme injection to remove unwanted filler. Sculptra is another valuable alternative with a slower onset and longer duration.

	Known recently as "volumizing," or volume enhancement, these techniques give patients the opportunity to restore or enhance facial contour without surgery.  They may help you achieve a more youthful appearance. 

	When you call, inquire about each surgeon's experience, and they may put you in touch with prior patients.  Best Wishes.

Mitchell Schwartz, MD - Account Suspended · Answer

Stimulatory fillers such as Sculptra and Radiesse have given physicians and patients a new dimension in facial contouring by revolumizing the aging face through a minimally invasive approach. Injections are well-tolerated by patients. They have a low incidence of side effects and result in high patient satisfaction. Volume replacement is now the most widely used nonsurgical cosmetic treatment for the correction of contour deficiencies and wrinkles of the face without the risk, recovery time, and expense of major surgery.

	Wrinkle lines or folds are really just the first obvious visible signs of a slow progressive change taking place in all structures of the face. Sculptra and Radiesse are not injected directly into these wrinkle lines and folds, but rather into multiple areas of the face to treat the volume loss that leads to their appearance. This leads to the subtle and natural-looking results that are so often desired. Patients don&rsquo;t want to look &ldquo;done&rdquo; but also don&rsquo;t want to look &ldquo;tired&rdquo;. Seemingly small changes in shape, proportions, balance, and symmetry can have a surprisingly large effect on our perception of the aging face. I frequently inject men with these fillers. You will not look worse after they have worn off. You will simply look the same as if you never had treatment.

Francis R. Palmer, III, MD (retired) · Answer

I have used various implants and fillers to shape the cheeks for well over 20 years both in men and women.  Since you're asking about fillers, for cheek augmentation, I'll concentrate on answering that for you.  Here's what you should know about using fillers for cheek augmentation IMHO:

	
		Creating the propers shaped cheek using fillers requires the proper aesthetic judgement...ie knowing where and how much filler to use.
	
		Creating the proper shaped cheek requires experience using the right filler to accomplish the job as not all fillers are the same and do the same thing.
	
		If you do not follow steps 1 and 2 above then yes, you may wind up with cheeks and a face, that look odd, mishapen or over-done.
	
		Permanent fillers should not be used, to shape the face (cheek, chin and jaw line).  Fillers are meant to be placed within the fatty layer of the face.  This fatty layer sags with age and moves towards the nose creating the nasolabial folds.  Permanent fillers, lasting longer than 3 years IMHO, will not stay over the cheek but will sag and shift creating larger, fuller nasolabial folds.
	
		I prefer using Perlane or Radiesse to shape the cheeks.
	
		Both of the fillers, mentioned above work quite well and are associated with minimal bruising, swelling and down time with Radiesse greater than Perlane in that regard.  Radiesse is a bit more lumpy and swollen than Perlane but lasts sevral months longer.
	
		Perlane lasts about 9 months and Radiesse 12 months but both will eventually dissolve allowing your cheek to go back to the way it was before the fillers, without consequence.
	
		Should you like the cheek augmentation but tire of having filler injections repeated, you may consider cheek implants for a permanent effect.

What Are The Risks That Come Along With Cheek Fillers, Is It Something I Have To Commit To Once I Start?

Answers (4)

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