Filler or fat transfer for submalar and buccal area?

Question

Age 32, petite,(5'1, 105 lbs.) I have previously had HA fillers to cheeks and tear trough, great result. However, I am still somewhat hollow in the Submalar and Buccal areas. Have had a series of Sculptra injections and I am very underwhelmed (6 months post 3 vials.) Considering fat grafting but also curious if a thicker HA filler like Voluma could augment this area. I have heard different things from different providers. Fat transfer is a little frightening to me.

Michael P. Morrissette, DDS, FACS · Answer

These are all excellent treatment options. Fillers like Voluma, sculptra, and autogenous fat can all help provide lift and volume in this area. Using your own fat is safe and effective for volume augmentation. It causes little to no swelling and feels soft and natural. For a more permanent solution, you might want to consider silicone cheek implants. They are placed through an intraoral incision and are permanent yet can easily be removed. I would recommend a consultation with a surgeon who performs all these treatment options in their office.

Jason Emer, MD · Answer

I use sculptra for collagen production in the face then voluma or radiesse to cheeks to increase volume. Implants or fat are alternatives. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question.  I'm sorry to hear that you were underwhelmed by the results of your Sculptra treatments.  It's difficult to make exact recommendations without assessing you in-person, or at least reviewing your photos.  That said, hyaluronic acid fillers can be used in the submalar and buccal area with excellent results.  I personally prefer Vollure or Juvederm Ultra Plus in this area over Voluma - these are softer products, and are better for superficial injection into the cheeks.  Fat grafting is also an excellent option, but is more invasive.  I would recommend seeing a cosmetic dermatologist or plastic surgeon for a consultation.  Best of luck!

B. Edward O`Dell, MD · Answer

Thanks for your question.  Voluma and other fillers added can be an excellent combo in your case.  However, I have used fat transfer in those areas in all ages with good and lasting results.  Higher volumes above the 1-1.5 cc volume in filler syringes can be used in fat transfer so that a really nice lift and fill out can be done all over the face in each needed area.  Being 32 yo you should get great longevity of the fat... far longer than any filler will last.  Fat transfer is safe when done by an experieced injector.  For faces requiring 3-4 vials of filler the fat transfer is a safe and longer lasting alternative.  Hope this helps.
Dr. ODell

Alex Eshaghian, MD, PhD · Answer

Thank you for
your question wright1. Fillers are used to
restore lost volume in and enhance the appearance of the face. It is difficult to make an assessment without photographs. However fillers such as Voluma can provide enhancement of the cheeks depending on the individual. Please
consult with a doctor for specific recommendations.  Good luck!

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