Cheek Filler or Sculptra Right for Me? Tired of Looking Tired. (photo)

I am 41 yrs old and would like to look rested not superficial. I began botox 6 mos ago (2 diff visits) for crow's feet/between brows & on last session noticed some slight drooping (eyes& lips) but i know will wear off. Also had Belotero (2 vials@ diff vists) for tear trough. So far okay, but am now considering if cheek filler is right for me. I have a round face with strong facial features & do not want to look bloated. Thank you for advice.

Doctor Answers 6

41 and do NOT want to look tired anymore

Leticia, you do have some loss of volume to the cheek region; however, you do not need a lot of correction.  Sculptra or Radiesse are great products to help correct this volume loss and you will look less tired.  Another suggestion I agree with in previous comments is to address your chin area.  As injectors, we not only fill in lines or fill volume lost, but we look at the ENTIRE face to assure balance.  If you only treat the cheeks, the chin and lower face may not be proportionally balanced to the rest of the face.  I encourage you to consult with an experienced injector who is able to evaluate and treat the entire face, not just fill in lines.  Best of luck to you.

Rogers Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

Tired of Looking Tired

Hi Leticia-

"Rested and not superficial" always should be the goal. The ideal approach to restore a natural and rested appearance is a global one - looking at the whole face instead of focusing on one specific area (cheeks).  Both Sculptra and "site-specific" dermal fillers used to address the "downward drift" of facial features are appropriate choices.

Sculptra is the preferred choice to restore volume loss in the lateral areas of the face. By addressing these areas (think temples, area in front of ears, jawline, and chin), a natural- looking "lifting" effect can be achieved.  Several sessions will be required; however, the "natural" looking restoration that can be achieved with Sculptra is like no other filler. Because results are not immediate and because Sculptra can change facial shape, I prefer to inject less product over more sessions (this approach also will alleviate your fear of looking "bloated").

For "instant gratification" in improving facial contours, using a "site-specific" filler (Juvederm, Restylane, Perlane, etc.) to fill the depressed area from tear trough through the central cheek, will yield nice results. A little chin augmentation with filler also would be great for better balance of your features.





Allison J. Stocker, MD
San Antonio Dermatologist
3.0 out of 5 stars 2 reviews

Filler??Which one Sculptra or Radiesse

I think that you would do well with either Sculptra or Radiesse with the right injector. The Radiesse would give you immediate results as the Sculptra would be more of a process. If you were my patient I would probably encourage you to use Radiesse first and if you loved having volume might use Sculptra next time as it will last longer. 

Jo Herzog, MD
Birmingham Dermatologist
5.0 out of 5 stars 18 reviews

Filler Suggestions for a Tired Appearance

Hi Leticia.  We also would suggest more product for the tear trough area under the eyes.  This area is very important to getting rid of the tired appearance and you are still looking tired.  We would recommend 1-2 CC's of Restylane.

In the first photo where you are looking up, there is some volume loss right below the cheekbones which could be improved with Sculptra, Radiesse or Perlane.  Perlane is the safest, cheapest and easiest to use but also does not last as long as the other two.  Radiesse is longer lasting but more expensive than Perlane and finally, Sculptra has very nice lifting benefits because fo the collagen stimulating effects.  It also has a 2 year duration, but is more expensive than the other two.  

All of these are good options to choose someone that knows how to use all three.  Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

In my opinion, Sculptra and Belotero are not good options for what you need.

My bias is that I do not like products that drift or diffuse (Belotero).  I do not like products than depend on an inflammatory tissue response for an effect and are difficult to remove if there is an issue (Sculptra).  In analyzing your photos, you are not adequately treated in the tear trough area, nasolabial fold, or prejowl sulcus.  The tear trough is best treated with Restylane.  The other areas would benefit from either Restylane or Perlane.  I would also recommend you consider subtle lip edge treatment (executive lip edge treatment).

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Considering cheek fillers

I would say that it is possible to place a filler in your cheeks to give some improvement without making you look bloated.  The cheek area itself does not need very much and you might also consider some filler on the sides of your chin along your jaw as well.  There are a variety of fillers, including Sculptra, that could be used.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

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.