Are 4 Vials of Perlane Too Much for Cheek Augmentation?

I'm 37, and over the last month have had 3 vials of Perlane in my cheeks, to correct flatness caused partly by aging, and partly due to the natural shape of my face (long and thin).

I loved the results, and it's still better than before, but now the swelling's gone down. I think I'd like a bit more. I'm worried that I'm metabolizing it away really quickly though, and it will just be a waste. Is 4 vials a bit overkill? What do you think? Or could this be quite normal?

Doctor Answers 10

Perlane and amount required for effectiveness

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It is very difficult to answer your question without first viewing a photo of the areas you are describing or seeing you in person for a full assessment. It's not overkill, to use 4 syringes, especially if the volume loss is substantial.

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

How much Perlane for cheeks?

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Greetings Jane~

There is no magic number that is ideal for every patient when it comes to fillers like Perlane. Treatment with 3 syringes is not uncommon, nor is 4, to achieve sufficient projection and volume in patients that don't have much to begin with. After swelling diminishes after the initial treatment, it is not unusual for patients to want more.  You may also consider using Radiesse for cheek too provides good structure and longevity.  We have had great results with it and it can be used in conjunction with Perlane.

Good luck~

Dr. Grant Stevens

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 152 reviews

How Much Perlane is Too Much for Cheek Augmentation?

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No, four vials of Perlane is not too much. I have patients who have had over 10 vials in their face at one time. It all depends on what your personal goals are for volume and also what your baseline is. From your comment, it sounds like this is something you want, but it’s important to make sure you go to someone who is ethical who is not just trying to sell you product, but instead will work with you to achieve your goals within the realm of what is possible.

Timothy Jochen, MD
Palm Springs Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Are four syringes of Perlane too many?

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It is certainly possible that you require more than three syringes of Perlane. This completely depends on each patient's needs and facial structure. The cheeks tend to require more volume than other areas like the nasolabial folds, since the cheeks have a much larger 3-dimensional structure.

Ryan Greene, MD, PhD
Fort Lauderdale Facial Plastic Surgeon
5.0 out of 5 stars 85 reviews

4 vials of Perlane inthe cheeks

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It is entirely up to you and the doctor to decide if you need more. If the initial swelling has gone down and you feel it is a bit flat, you may very well need another to "top it off.:"

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Are 4 Vials of Perlane Too Much for Cheek Augmentation?

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Four vials of Perlane is not excessive. Some patients require less/more syringes of Perlane depending on the results they would like to achieve. The manufacturer recommends anywhere from 4.5 months to 9 months for follow-up treatments. We have also noticed that patients who followed the treatment regimen regularly, they are seeing the results lasting up to 18 months.

Kenneth Bermudez, MD
San Francisco Plastic Surgeon
4.9 out of 5 stars 16 reviews

Amount of Perlane depends on facial structure and patient preference

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Hi Jane,

Although 4 Syringes of Perlane is not necessarily too much, it all depends on your facial structure and your personal preferences.

You mentioned "metabolizing" the product. If the product is not lasting, then it would perhaps be because it is injected incorrectly. If Perlane is injected too superficially or too deeply, it can have an effect on the duration of the product. If you like the results, it sounds like this is not the case and that you just need a bit more to be satisfied. Sounds ok if you have another syringe. Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Fillers for volume restoration of the face

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This can be very normal. Some people just have a narrow sunken cheek structure and they may need more than 4 syringes of Perlane, Radiesse, Evolence to improve the appearance. Sculptra is a volumizer as well, and works by stimulating your body to make more collagen. It is done differently than the above fillers. Rather than getting an immediate effect, the Sculptra is delivered every six weeks or so. The volume, which is mostly a liquid used to dilute the product, vanishes within a day or so, and the volume that you see immediately after the procedure is gone quickly. Then the body builds up the collagen and you see a gradual improvement.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Perlane for cheek augmentation

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Perlane is a great product for cheek augmentation and midface volume correction and lift. Depending on your anatomy, 3 to 4 vials of Perlane could be the volume you need for full correction. It usually lasts very well in the cheeks, and the more you have in there, the longer it lasts. For most patients, with the good volume correction achieved in the beginning, they only need touch up treatments every 6 - 9 months.

Stella Desyatnikova, MD
Seattle Facial Plastic Surgeon

Whatever Looks Best

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This would depend on the judgment of you and your physician. There is not problem with placing four vials of Perlane. It is done quite commonly. One of the advantages of hyaluronic acid fillers is that, aside from some post-op swelling, what you see is what you get. If your cheeks need four syringes, and you can afford it, why not?

However, if such volume is needed, you might consider Sculptra. It lasts longer and can give a more natural appearance.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.