Doctors: what can I do to fill out my buccal area hollows when I don't want any cheek implants/fat grafting or Voluma?

I understand your concerns about the various options for achieving fuller, rounder "baby cheeks," especially given the conflicting advice and risks associated with different treatments. Here's a breakdown of the available options and alternatives that might help you achieve the look you want, focusing on safe and effective solutions for your goals.

1. Cheek Fillers (Hyaluronic Acid-Based):
Voluma or Restylane Lyft: While Voluma is commonly used for cheek augmentation, it is true that some practitioners avoid placing it directly in the buccal area because it can create an unnatural or overfilled look in this region. However, fillers like Voluma or Restylane Lyft can still be used in the midface or cheekbones to create a more rounded appearance if done conservatively.
Pros: Reversible with hyaluronidase, immediate results, customizable for a natural look.
Cons: Temporary, with results lasting 12-18 months, and should be done by an expert injector to avoid the "puffy" or unnatural appearance.
2. Fat Transfer:
Fat Grafting: While you're understandably hesitant about fat transfer due to weight fluctuations, fat grafting can still be an option. When done by an experienced surgeon, fat can be precisely injected into the buccal and cheek areas to achieve the fuller, rounder look you want.
Pros: Long-lasting (potentially permanent) results, natural-looking fullness.
Cons: Some of the fat may not survive the transfer, and there's a small risk of asymmetry. Weight changes can affect the fat graft over time, but results can be stable with weight maintenance.
3. Combination Approach:
Cheek Filler with Buccal Fat Preservation: Instead of focusing on the buccal area directly, a skilled injector could use fillers in the malar region (the upper part of the cheek) to lift and enhance the natural cheek contour. This combined with minimal filler in the lower cheek could give the full, round appearance without overfilling.
Pros: More control over the outcome and ability to blend volume throughout the face.
Cons: Requires a highly skilled injector to balance the look.
4. Sculptra:
Collagen Stimulator: While you mentioned fat transfer as a concern, another option is Sculptra, which works by stimulating collagen production in the injected areas. It’s not an immediate filler, but it gradually builds volume and can give a more natural, long-lasting result.
Pros: Gradual and natural volume increase, long-lasting (up to 2 years or more).
Cons: Takes multiple sessions to see results, and it’s not reversible like hyaluronic acid fillers.

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

It seems that your fear is based on very strange data? All procedures above, when properly used in well selected patients, should have minimal side effects/complications. Selection of right tprocedure will depend on your clinical presentation and your goals. In-person evaluation and discussion about your options with an experienced board certified plastic surgeon would help to better understand soft tissue augmentation including correction of buccal areas. Good luck.