My Cheeks Look Too Plump After Perlane!

I recently had Botox and Perlane for my cheek area. It looked great the first time, so I came back for a follow-up. We thought the right side of my face looked a bit flatter than the left, so I agreed to have a bit more filler on it. He did some touch-up on the left side too.

Now the results are disastrous--my face looks good when I make no expressions, but my cheeks look too plump when I smile. It looks so wrong on my heart-shaped face! Will this eventually go down, or can I have it removed?

Doctor Answers 17

One of the good things about temporary fillers is that they are not permanent.

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Time will take care of this, but it will probably take several months. The skin injected with Perlane is getting " bunched up " when you smile and so it creates too much fullness.

Perlane can be dissolved with injections of hyaluronadase, but these injections can also cause irregularities in a large area. So, hard as it is, I would just wait, knowing that you will look better in a few months.

Manhattan Plastic Surgeon

Better is the enemy of Good

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Baby Face,

Sometimes in an effort to achieve perfection we turn a good result into something less desirable. This is the best argument for experience in the cosmetic field -- knowing when to stop.

One of the negative attributes of Perlane is that it is a temporary filler and lasts on the order of 6-9 months. In your situation this a positive attribute, since your results are dissatisfying.

Also, the degradation of the product is gradual so that by 6-9 months the product is completely dissolved. This means that your cheek fullness will improve in less than 6-9 months and you may be ecstatic with the appearance by 6-8 weeks.

For this reason, I would consider holding off on injecting Hyaluronidase to dissolve the Perlane, as every intervention brings with it a certain amount of uncertainty and risk, and reassess after this time.

Good luck!

Will eventually go down, but there are things you can do.

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I am sorry that you are not happy with the result of your injecttables. First, you should let your doctor know that you are unhappy and he/she may be able to give you options for treatment.

You said that you had Botox and Perlane to treat your cheek area. Botox and Perlane do different things. Botox paralyzes muscles to stop getting deep wrinkles and lines that are made with movement. I am not sure where you doctor treated you with Botox in your cheek. Usually we use Botox to treat crows feet (lines radiating out from the side of your eye especially with smiling) and to treat lines on the sides of the nose.

About the Perlane-this is hyaluronic acid filler that eventually goes away in 6-8 months time. The plumpness of your cheeks could be due to swelling (you did not say when you had the injections done). The plumpness could also be due to too much Perlane. If you do not want to wait for the Perlane to go away you can use a medicine called Hyaluronidase. The can be injected into the area where the Perlane was placed and will help dissolve the Perlane.

I wish you luck and hope that you feel better soon.

Swelling hiding results

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Swelling could be hiding your results, making your cheeks look plumper than they should. I suggest you wait for two weeks for the swelling to subside, then return to your injector to discuss your results. Hyaluronidase can be injected to dissolve excess product.

Wait, then Hyaluronidase if necessary

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I would advise you to wait 2 weeks for everything to settle out.  If you still hate it, ask your practitioner to dissolve it with hyaluronidase.  That is the beauty of hylauronic acid fillers... reversible.

Perlane and over treatment

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You should consider posting a photograph to show your area of concern, but yes, you can have it removed and your provider should be happy to follow up with you to address your over-treatment.

Solving the problem of too much Perlane or Juvederm injection

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When too much hyaluronic acid (HA) filler is injected and the affected areas get too puffy, there is a simple cure.  Injection of the enzyme hyaluronidase will break the HA filler into small particles that get metabolized by the body quickly, almost like sugar.  Usually normal or baseline appearance can be restored within days.  Our patients are reassured that Perlane, Juvederm and Restylane (as the well as the new HA filler Bolatero) are completely reversible.

Robert A. Weiss, MD
Baltimore Dermatologic Surgeon
5.0 out of 5 stars 13 reviews

How long will this Swelling last?

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  How long has it been since you were injected this most recent time?  If less than two weeks, wait some more for any residual swelling to go down before taking any corrective actions.  If it has been longer than two weeks and you just can't live with the results, there is a product call hyaluronidase that will desolve this filler but may leave you uneven again.  Your surgeon can inject this into the same are in order to disolve some of the filler you had put in. 

   If you can live with the results, then wait it out.  The filler is elliminated from your body slowly and over the next few months will go away enough so that if may not bother you anymore.  Good luck, Erez Sternberg, MD.

Erez Sternberg, MD
Jacksonville Plastic Surgeon
4.9 out of 5 stars 33 reviews

Perlane can be Reversed

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Baby Face - How long ago was it that you had the injections?  I would recommend waiting at least 2 weeks for the swelling to subside before making a decision.  If after 2 weeks you still think your cheeks are too full, there is a product called Vitrase or  Hyaluronidase that can dissolve the Perlane almost immediately.   If you were to nothing at all, Perlane is temporary and it will dissolve and go down on it's own.  Perlane will last approximately 8-12 months. 


Hyaluronic Acid Treatments Can Be Reversed

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Fortunately, hyaluronic acid treatments, such as Perlane can be reversed with an enzyme called hyaluronidase. If you choose not to use hyaluronidate, fortunately the Perlane will wear off in about 6 months to a year.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
3.9 out of 5 stars 14 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.