Late 20s female - Options for cheek augmentation for a fuller more youthful face? (Photos)

Question

My cheeks are not as full & round as I'd like. I'm considering cheek implants because they're permanent and more cost effective than fillers, but I also read that fat transfer is "semi permanent." How does fat graft or fat transfer compare to implants when it comes to durability and long term results? and which do you prefer? I'm looking for a natural but subtle change that won't be obvious, but I'm also concerned with the durability of the results, as well as the down-time required. Thanks!

Scott Trimas, MD · Answer

The advantage of using cheeks fillers or volumizers is that it gives you a good idea of what augmentation will look like and if you do not like the effect, then it will resorb over time and can also be reverse. Fat is somewhat permanent depending upon your ability to retain it in that area. We have found that fat in younger patients lasts a lot longer than older individuals. Sometimes multiple augmentations may be required. Also, some of the injectable fillers can last for many years, 2-5 depending upon the patient. Of course, the advantage of an implant is that it is permanent; however, there are risks like infection, migration and asymmetry of the implant especially if the cheek bones are not the same. In addition, the implant edges may be seen in thin individuals. I would recommend a consult with a facial plastic surgeon.

Heather Lee, MD · Answer

Consider using fillers such as Sculptra or Voluma which once you receive full correction can last up to three years.  The benefit of using a filler is that you can work with your physician to gradually build to your desired look to achieve the natural yet subtle change you are seeking.  The good news about fillers is the downtime is minimal compared to other interventions.  
Once you have achieved the desired contour, then you can consider if this is something you'd like to make permanent with a silicone implant.  Fat injections are also used in facial contouring procedures, but in your situation, I would recommend the above and encourage you to speak to a experienced surgeon who could further discuss which intervention is right for you.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Based on
your photographs, you may benefit from either fat grafting or malar implants. Malar implants can be
placed as a permanent way to gain volume in the cheek.  I always use
medpor implants with screw fixation.  Silicone malar implants tend to
have a high rate of malrotation over time.    Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Jason Emer, MD · Answer

Volume and contouring of the face can be improved with well-placed fillers (Voluma, Radiesse, Bellafill) and Sculptra. Fat or implants are alternatives. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

William Portuese, MD · Answer

Cheek implants are placed for patients who have a flat mid face and a flat maxilla, and they offer a volume restoration to the mid-face area on a permanent basis. We do not perform fat injections to the mid-face for a variety of reasons. Cheek implants are manufactured in a large assortment of both sizes and shapes which is best determined at the time of the consultation and  examination. For diagrams of the implants, and many before-and-after examples, please see the link and the video below

J. Charles Finn, MD · Answer

I would advise against fat grafting at your young age - results are unpredictable and can change over time, especially with weight gain. The transferred fat retains the metabolism of the donor area. Cheek implants are fine, but seem to be a drastic solution for someone as young as you unless you have a real bony deficiency. Your face is still changing and maturing, I'd recommend a filler - results last years, shaping can be tailored to your anatomy and desires, and is reversible!

Darryl J. Blinski, MD · Answer

I would offer the Y Lift (liquid FaceLift option) either just weeks or full face. In the Y lift the deep HA filler injections will greatly improve the facial youthful appearances. I would use 8 to 10 syringes. fees in $8,000 ranges.

Richard W. Fleming, MD (retired) · Answer

At your young age I would recommend silicone cheek implants which will give you a permanent result. Although recovery can be longer than other approaches repeated procedures will not be necessary.

Late 20s female - Options for cheek augmentation for a fuller more youthful face? (Photos)

Answers (8)

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