Avoiding "monkey face" with fillers? Where should I be injected? (photo)

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. To address nasolabial and marionette lines while maintaining a natural, non-puffy look, the key is to inject strategically, not directly into the lines themselves. Injecting in the cheek area—specifically in the mid-face—can help to lift and smooth these lines by restoring volume in the regions that naturally lose fat with age. This technique avoids overfilling the lines themselves, which can lead to a "puffy" or unnatural appearance, often referred to as the "monkey look." The goal is to enhance the cheekbone area and provide subtle volume where it’s most needed, which naturally lifts and softens the nasolabial and marionette lines without making your face look fuller than it should. To avoid hitting any arteries, experienced injectors use careful anatomical knowledge and advanced techniques, such as using a cannula instead of a needle, which significantly reduces the risk of bruising or hitting a blood vessel. I hope this helps and best of luck!

It is important to begin with an experienced injector for your treatment. Ask to see before/after photos of other patients and discuss your goals for treatment as well as concerns. There are different fillers available that are designed for specific areas. For example Restylane Lyft is great for the cheek area and Juvederm Volux is great for the jawline. I've included a video I hope you find helpful.

our concerns are valid, and it's important to approach filler treatments with both precision and care.

Injection Sites: To avoid the "monkey face" or overfilled appearance, many practitioners focus on injecting fillers into the mid-cheek area rather than directly into the nasolabial folds and marionette lines. By enhancing the volume in the cheeks, the lines can appear softer and more natural. This technique helps maintain a balanced facial contour.

Avoiding Arteries: It's crucial to have injections performed by an experienced professional who is knowledgeable about facial anatomy. They will use techniques such as aspiration and slow injection to minimize the risk of vascular complications. Ultrasound-guided injections are becoming more popular for added safety.

Type of Filler: Hyaluronic acid fillers like Juvederm and Restylane are commonly used for these areas because they are versatile and can be dissolved if needed. These fillers can also be used under the eyes to address tear troughs, though it requires a skilled injector to avoid complications such as puffiness or a bluish tint.

I recommend consulting with a board-certified dermatologist or plastic surgeon who specializes in facial aesthetics. They can provide a personalized assessment and recommend the best approach to achieve your desired look safely.