Cheek Implants or Permanent Filler - How Do I Decide?

For cheek augmentation, how do I decide between getting cheek implants or having a permanent filler injected into my cheeks?

Doctor Answers 14

Filler vs Implants in the face

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The decision on whether to use a soft tissue filler or a solid implant for volume augmentaiton of the face is purely based on whether the problem is related to skeletal underdevelopment (hypoplasia) or soft tissue deficiency.  The former may treated with an implant and the latter with a soft tissue filler. However, the surgeon needs to be aware of the patient's goals and recovery. The patient may choose to use a filler to correct a skeletal problem to have a faster reovery but a temporary result. Trying to compensate for skeletal loss with a filler can only work to a certain extent, howerver. If too much filler is added, the face loses definition and has a soft doughy look. Also, there may be other bone related issues contributing to the problem. Make sure you go to a surgeon who is facile in all techniques so the pros and cons of each can be discussed equally.

Washington DC Plastic Surgeon

Real cheek implants are permanent

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This is a simple question......If you have undersized cheek projection and you want a permanent solution that looks and feels natural find a surgeon with real experience in cheek implants. Fillers on the other hand are all temporary, and actually hard to make even looking....true they don't involve surgery and have almost no complications but its a poor trade off to have to do something once or twice a year at significant expense just to maintain your cheek bones. Cheek implants done by an experienced surgeon  take 45 minutes under local anesthesia and in 10 days most swelling is gone. Complications are rare and the results are permanent....before you get fillers make sure you consult a surgeon who does cheek implants and can show you numerous results of his work

Fat Injections or Fat Grafting Provide a Safe, Natural Looking Alternative to Implants

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Facial Implants for facial bone augmentation

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.

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.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Cheek Implants or Permanent Filler - How Do I Decide?

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Cheek implants are permanent and can result is a large degree of augmentation. They will cost less over the long term. Downsides are possible complications such as resorption or nerve compression. Fillers are easier to perform with less down time but generally are temporary, so they will have to be repeated. Fat grafting is one of the best fillers for cheeks as it is more permanent and has minimal complications.

Permanent injectables have no place in medicine

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In regard to cheek implants over time there is fat-loss under these devices,  The  implants then develop a significant depression below them that seems visually very peculiar  , Using injectables to create naturally appearing cheeks is not simple but is very rewarding,Permanent fillers  should not be used in that they can cause inflammatory reactions and move over time. I prefer Juvederm and it should be used to create  the lateral ramus of the cheek and not a ball like structure under the eye 

Arnold W. Klein, MD (in memoriam)
Beverly Hills Dermatologic Surgeon

Cheek Implants, Cheek Augmentaion, Cheek Enhancement

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This is a great question that I answer during patient consultations each and every week.  I have performed Cheek Augmentation with Cheek Implants for over 20 years.  Here are the issues with using a permanent filler, in the face to shape the cheeks:

  • The current Fillers that are available should be placed in the subcutaneous fatty tissues
  • these fatty tissues shift with gravity and aging towards to nose and mouth creating the nasolabial folds and jowls
  • if permanent fillers are injected over the cheek area, within this fatty tissue layer, it will eventually shift as described above
  • because all fillers can create granulomas, permanent fillers can and do cause granulomas that require surgical removal resulting in a scar on the face

 In my opinion, there are to many drawbacks to using permanent fillers for Cheek, Chin and Jaw Line Augmentation with the current fillers.   I prefer to use temporary fillers in these areas (Radiesse and Perlane) or to use Cheek and or Chin Implants made of silastic.  When a permanent filler is available that can be injected directly onto the bone that will become part of that bone, I will add that filler to my treatment regimine and not until.


Be sure that the plastic and cosmetic surgeon, you select, understands and follows the proper aesthetics of facial beauty for the creation of a naturally, more attractive face.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Cheek Implants vs. Permanent Fillers

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Cheek implants are the Gold Standard, compared to a permanent filler. Implants are also a reversible operation, adding a feature not available with injectables.

Once you have the permanent injection, it cannot be removed.

A temporary filler, or even sterile water, can be injected into your cheeks, giving you an idea of what a cheek implant would look like on your face.

Darrick E. Antell, MD
Manhattan Plastic Surgeon
4.7 out of 5 stars 37 reviews

Fillers vs Implants for Cheek Augmentation

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Other than fat transfer, there is no other safe permanent filler. In particular - STAY AWAY FROM LIQUID SILICONE INJECTIONS as they can lead to serious complications even years later. Lipoinjection or Fat transfer I believe is a great way to help correct asymmetry of facial soft tissue deficiencies as well as to augment the cheek bone area giving the illusion of high cheek bones. It is a great technique with long lasting results which can be added to when there is continued loss of native fat in this area as part of the aging process. Of interest the transfer fat that survives tends to stay better than the native fat as it retains the nature of the donor site rather than the recipient site. Since the advent of fat transfer the number of implants I use and recommend has decreased significantly as this is such a good technique. That being said the advantage of Cheek Implants is that they are predictable and permanent. 

Fillers have many advantages over implants for cheek augmentation

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Having strong cheek bones defines a face and makes it attractive.  Most models and actors have great cheek bones.  Most of us ordinary people have average cheek bones, and a few of us are unlucky enough to have deficient cheek bones.  With deficient cheek bones, your face may appear bottom heavy, your nasolabial folds may deepen, and your face may develop deep hollowing and dark circles.

Cheek implants are very effective at improving this problem, but they can have a high complication rate.  They also involve a moderate amount of swelling.  For a surgeon to be very good at using these implants they must have a lot of experience with them.

Fillers on the other hand are easier to customize, have a fraction of the swelling, and allow the patient to participate in the sculpting of their face.  Most fillers are not permanent at the time I'm writing this response, but Radiesse lasts 6-9 months and ArteFill may give longer lasting results. 

For an example of using facial dermafillers, please click the link below.

David C. Mabrie, MD
Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 157 reviews

Cheek implants vs permanent filler

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Cheek implants are a great option for cheek augmentation. They are very predictable, reliable, and have low complication rates. They are also permanent and as a result, cost less in the long run when compared to repeated injections of temporary fillers.

I typically do not use permanent fillers. Permanent fillers have the risk of asymmetry which is not easy to correct, are difficult to get even, and have a risk of nodule formation and infection. 

Temporary fillers like the commonly used hyaluronic acid fillers are a great option as well, but do require follow up injections every 6-24 months (depending on the product and patient) in order to maintain the result. Other products like Radiesse or Sculptra are made up of different materials from the hyaluronic acid fillers, but can also work well in the cheek areas. These products are still not a permanent solution and will be expensive to maintain over the years. 

Overall, cheek implants are a great option for a patient who has tried fillers to the cheeks and has been happy with the result, but simply wants a permanent solution.

Matthew Richardson, MD
Frisco Facial Plastic Surgeon
5.0 out of 5 stars 7 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.