I am 35 years old and have successfully used Restylane twice in the past for my severe nasolabial folds. But I also wonder if I can "thicken" my sunken cheeks and fill out my under-eye puffiness. I have a very narrow, upside-down elongated triangular type face to start with. I wonder, is Juvederm a better option for me? If not, what are my other options?
Juvederm for Narrow Face with Sunken Cheeks and Deep Nasolabial Folds?
Doctor Answers 7
Voluma for Volume Replacement for Narrow Face with Sunken Cheeks and Deep Nasolabial Folds
Juvederm is an excellent filler for the deep nasolabial folds
Juvederm is an excellent hyaluronic acid based injectable that can be used effectively for facial contouring.
Juvederm is commonly used around the lips, the smile lines, the marionette lines, under deep wrinkles, under deep scars, and even under the area of the eye.
From your description, it sounds like you would benefit from a dermal filler to several areas of your face. Juvederm is an excellent filler whose smooth qualities allow for its injection in the lips and in the nasolabial folds. However in patients that have very deep nasolabial folds or sunken cheeks, we often recommend other fillers as well such as Radiesse or Sculptra. Radiesse is an excellent filler for the very deep nasolabial folds as it can correct these areas and has a very long longevity that the patient can enjoy.
Hollow cheeks and tear troughs
Multiple different regimens can help you. Sculptra or Radiesse can be injected to treat the hollow cheeks. The tear troughs can be improved with Radiesse, Juvederm, or Restylane.
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What is best for hollow cheeks and nasolabial folds?
I think that Juvederm ultraplus and restylane are equivalent but I would recommend perlane to help enhance the nasolabial folds and hollows of your cheeks. I think you look great and a little perlane will go a long way to helping to fill the hollows of your cheeks and making the nasolabial folds softer for a longer period of time.
There are better option, but juvederm is best for the eye hollows
Juvederm is a great "filler" and I use it extensively in my practice. It is made of the essentially the same stuff as Restylane—that which you have used in the past—but it tends to be a little smoother and easier to inject in my hands. Most plastic surgeons agree on this. Because the skin in the eye hollows is very thin, Juvederm is probably the best thing to inject there as it is not a very thick substance. However, it is not as good for really deep creases like the cheek hollows or nasolabial folds.
For these problems, the thicker Radiesse works better to fill the hollows and the nasolabial folds and it typically requires less syringes to fill these hollows (often resulting in a lower cost to the patient).
Finally, Radiesse lasts longer (12 months for Radiesse vs. 6 months for the Juvederm). Another option that can be used is fat. This is a more complicated and costly procedure but has the advantage of being permanent.
You do have better options.
For the areas that you are concerned with - the cheeks and nasolabial folds, you have several options including other fillers such as Sculptra which is excellent for the cheeks (usually requires a few injection sessions but can last well over a year), and Radiesse (calcium hydroxyapatite, lasts typically longer than 12 months) which is good for cheeks and nasolabial folds.
Fat transfer would be another option for you. In about half of fat-transfer procedures, the fat lasts indefinitely.
Yet another option you might want to consider is cheek implants. You would need to find an experienced and qualified plastic surgeon for this, but I have seen some impressive results with such implants.
Sculptra is a better option for volume enhancement of the cheeks
Juvederm and Restylane are great fillers for correcting wrinkles and creases as well as for lip augmentation. However, cheek augmentation is usually best performed using Sculptra or fat transfers due to the volumes that are needed to correct these larger defects. These latter two also last longer and can be used to volumize other areas of the face like the temporal areas as well as provide overall volumization of the face.
I hope my answer was helpful.