Fat Injections, Cheek Implants, Injections, Best for Thin Face?

hi, im a 21 year old female. Im trying to find the best option to to make my cheek area appear noticeably widder, more oval like. I have a long face and being thin in face doesn't help the situation. I've been thinking about this for some time now and come to find that a surgical procedure is the only option. Just wondering what would be the best option for my problem, fat injections, cheek implants, or some sort of filler? also if I chose cheek implants, would they look natural?please help!!

Doctor Answers 10

Rejuvenation of the thin face

Structural fat grafting is a powerful tool for correcting one of the primary processes of facial aging: the gradual loss of facial soft tissue volume, which primarily represents the atrophy of facial fatty tissue. The importance of restoring facial fullness cannot be emphasized enough, for without it, very few facial cosmetic surgical procedures are truly rejuvenating. As we age the skeletal features of the face become more obvious, and create subtle visual clues that tell the observer 'this is an older person'. Fat atrophy is often very obvious when it appears as hollowness in the temple area and as flattening of formerly full cheeks, but can also exist as more subtle changes that still convey an appearance of advancing age, such as the development of a hollow in the space between the upper lid and eyebrow, or as indentations in a formerly smooth and gently curving jawline.

Lifting skin and trimming the excess has been the standard approach to the treatment of facial aging for centuries, but when performed without some means of restoring the youthful fullness of facial soft tissues, the result is an older-looking person with tighter skin. The word 'rejuvenation' means literally 'to restore youthfulness' or 'to make young again', so if the goal of surgery is to rejuvenate the face then it cannot be accomplished solely by means of redraping the skin and removing the excess.

In my practice fat grafting is not an afterthought that is thrown into the surgical plan for the occasional patient. It is a key component of almost every major facial rejuvenation surgery that I perform. It is in fact that very first part of the surgical procedure for my patients undergoing a full facial rejuvenation surgery.

Fat grafting also gives the surgeon the ability to provide a minimally invasive, quick recovery solution for some of the earliest signs of facial aging, in many patients long before they could or should consider a more involved (and much longer recovery) procedure like a facelift. Most people show evidence of facial soft tissue atrophy in their thirties, long before they develop the degree of skin laxity that warrants skin redraping and removal. So younger patients now have a means for 'turning the clock back' by maintaining or restoring facial fullness through structural fat grafting. These enhancements look beautiful and natural, not like surgery, and over and over I hear fat grafting patients tell me that "none of my friends or co-workers can figure out why I look so great".

As with any cosmetic surgical procedure, there can certainly be 'too much of a good thing'. Over-grafting of fatty tissue will distort facial features and produce unnatural proportions that look like surgery rather than appearing to turn back the clock. An important part of my preoperative evaluation is reviewing photographs with patients from their twenties and thirties (and from their forties for patients in their sixties and seventies). Such photographs are invaluable in confirming the manner in which a face has aged, and in planning a surgery that is designed to help a patient look more like their youthful self.

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.


Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 120 reviews

Try non-surgical options first and consult a reputable surgeon

You are young for cheek implants, but it is possible. A good starting point to know when you are ready for cheek implants would be to try an injectable filler to give you volume in your cheek area to see if you like the results. There are many excellent products available, and some last longer than others. Take your time to research before making any decisions. The most important factor is to choose an experienced, reputable facial plastic surgeon.

Cory Torgerson, MD, PhD, FRCSC
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 150 reviews

Treating a Thin Face

All of the above are definite possibilities for consideration for highlighting or widening the cheekbone region. Fillers and fat grafting may require additional treatments. However, these are usually spaced at least one year apart and often even several years apart. Implants are considered a surgical procedure and should be discussed with your surgeon, who will have the benefit of examining you and your facial structure in person.

Deason Dunagan, MD
Huntsville Plastic Surgeon
4.9 out of 5 stars 12 reviews

Best Treatment for Thin Face

I use implants, fat sculpting, and fillers, which are all excellent techniques to augment and sculpt a thin face. These procedures are individualized to meet the goals of every patient. Please send pictures or consult with a surgeon who does this work.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Facial filler, #Fat injection, or #Cosmeticsurgery Cheek Implant for Midface Augmentation

Hi 920140anon in missasauga, ontario,

Several cosmetic options are available to improve volume loss in the cheeks or midface. Volume loss is a natural progression seen with facial aging. Midface volume loss may also be seen earlier with genetic predisposition, medical conditions, severe weight changes, or medications too.

Treatment obviously is to add volume, typically. Injectable fillers with hyaluronic acid, Restylane, or Juvederm may be appropriate. Alternatively, longer acting facial fillers such as Radiesse or Sculptra provide longer-term improvement of the cheeks. All these injections are office procedures. A newer procedure, inappropriately labeled "vampire facelift", is to inject components of your own blood back into the cheeks. This blood injection is a newer procedure without long-term experience by plastic surgeons.

Other options include fat injections, which have been used for decades for facial rejuvenation. Lastly, cosmetic surgery with a silicone implant or midface lift may be more appropriate in selected patients.

There isn't one best treatment for facial plastic surgery procedures. Only after a comprehensive evaluation by a plastic surgeon specialist can he/she help determine appropriate options for you for natural cheek enhancement. Best of luck.

Dr. C

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Based on your age you may want to try fillers such as Radiesse First

The most important advice that can be given to you is that you should be evaluated by 2-3 surgeons specializing in facial plastic surgery.

Fat transfer may be a great option but there is no room for error as the results could be permanent and with your young age we have to be careful about the long term results.


Best option may be temporary fillers to make sure you like the results.  The decision can be made by working with you facial plastic surgeon.

Amir Moradi, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 7 reviews

Facial Augmentation with Fat vs Implants

Fat transfer to the face is a great procedure that gives natural, full results, and works very well in the cheeks and under the eyes.  Implants made of silicone also work very well and are permanent, which is a benefit.  Any other filler material (Radiesse, Restylane, Juvederm, etc) will only give temporary results, and will likely cost you more money in the long run.  Without your photos it is hard to make a specific recommendation for you.  Good luck!

Carey Nease, MD
Chattanooga Facial Plastic Surgeon
4.2 out of 5 stars 22 reviews

Fat Injections, Cheek Implants, Injections, Best for Thin Face

As stated by Dr Shafer Where's the PHOTO! But my plan of therapy would be start with Restylane 4 cc's filler to see if you like the effect. If happy I would use Selphyle regenerating filler or Radiesse. Finally an inplant can be the final choice. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Cheek Implants for Fat Injections

Without a picture or examining you, it is impossible to give you specific advice.  However, in most people I would suggest injections with Radiesse, Juvederm or fat transfer as a first line treatment.  Good luck with your procedure.  

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 77 reviews

Ways to widen cheek area in a thin face

Cheek implants are the best option for stable and consistent results in the cheek area. There are several different styles of implants including both malar and submalar. There are multiple different compounds that implants are made of. We believe the silastic silicone implants to be the best and most inert. Cheek implants are easy to reverse by just simply removing the incision for both placement and removal on the inside of the upper lip above the canine teeth. We do not recommend fat injections in this area because of the irregularity and resorption process that can occur which is too variable and inconsistent.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 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.