I feel that my cheeks look overfilled when I smile. My under eye area is dark. My subnasal area looks too wide. Options? (photo)

Question

Considering Prohilo or Radiesse. Anxious about lip lift so any alternative suggestions would be helpful. Can I have redensity 2 in under eye area without getting a further over filled look? Any comments about anything else appreciated.

Jason Emer, MD · Answer

Volume and particularly contouring of the cheeks can be created with well-placed fillers (Voluma, Radiesse, Bellafill) and Sculptra. Implants or fat are alternatives. Botox and radiofrequency can help slim and contour the jawline. Liposuction can help slim the face. Ultherapy, J Plasma and radiofrequency treatments can provide skin tightening and lift.

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting, and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Dermarolling several times a week should be started now (see link).  I recommend seeing an expert in facial contouring and sculpting.  Best, Dr. Emer

Raffy Karamanoukian, MD, FACS · Answer

Radiesse is an FDA-Approved filler that we use very frequently in our office to sculpt the contours of the face. Since we are a national center of excellence for filler reversal, we also encounter patients from other doctors' offices who wish to have Radiesse fillers removed for one reason or another. In our office, we employ a directed technique to visualize the filler material, if possible on ultrasound, and then use non-surgical methods to dissolve the filler or granuloma tissue using intralesional injections. There are many methods using a combination of enzymes, intralesional modulators of scar tissue, and Kenalog to help reduce volume and remaining filler. These techniques require meticulous attention to detail and can be performed at intervals of two to three weeks to achieve longterm effect.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Thomas Wright, MD · Answer

Sometimes that can be resolved by dissolving a little unless it was Radiesse, or by placing some laterally and in the temple, chin and jaw to give more balance. If getting lips done worry you, try just using a neuromodulator like Botox, Dysport or Xeomin before using  filler because it wears off in a few months.

Leonard Grossman, MD · Answer

For the last 26 years or more I've been recommending that the patients have their how long or so the face treated primarily with their own fat. When fat grafting is performed by a plastic surgeon with a lot of experience in such procedures, the results are natural and permanent. Fillers can frequently cause problems in the eye area as the skin is very thin and allows for movement as well as visibility of the filler. I hope this helps and good luck from New York City plastic surgery

I feel that my cheeks look overfilled when I smile. My under eye area is dark. My subnasal area looks too wide. Options? (photo)

Answers (4)

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