Neurotoxins such as Botox can relax muscles, but do not add volume, puffiness, or cause "chipmunk cheeks." When assessing the human cheek, there are certain contours that must be respected. If they are violated with fillers, the cheeks look unnatural and distorted. Expert injectors know where to place filler and how much filler to add. Simple anatomy avoids the chipmunk look. In my opinion, the cheeks are one of the most complex locations to fill naturally. When you visit an injector's office, look around the waiting room and ask to see before and after photos. This will prevent you from being injected by an inexperienced or incompetent injector that simply pumps volume.
I have not seen overfilled cheeks from the use of Botox or other neuromodulators but I have seen it in patients who have received injections of filler by other technicians and have come to me for help.Injecting fillers, such as Juvederm requires incredible skill, experience and the eyes of an artist/sculptor.Too many people are being treated by inexperienced individuals who seem not to know about normal facial anatomy and how to inject filler properly, to give a lovely, natural,refreshed look.Research before you have a treatment. When done properly, the results are great.