I have had 4 cheek implant revisions but finally removed them. Will I have a problem switching to fillers given the scar tissue?

Thank you for your question. You state t you have undergone 4 separate surgical revisions for cheek implants over the course of 25 years. The challenge you are facing is that subsequent surgeries still resulted in the implants looking too large,and not looking right for your face. Now that you don't have these implants, you want to know if you can have fillers, or is the scar tissue going to be problematic.
I can provide you with some guidance in the absence of a photo from my experience with comparable situations in my practice. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. I perform facial implants fairly routinely as well as provide non-surgical solutions such as something called Structural Volumizing that provides comparable results, and I I can give you some understanding of your options.
There is certainly a known issue with any type of facial implant, particularly in the midface, the cheek area, as one gets older. It’s more clearly well-defined in medical literature that facial aging is particularly characterized by a change in bone structure volume. Bone loss is important as part of the foundation in what the facial overlying can look like. When you appreciate that not only is the bone loss significant, but the soft tissue such as the skin, fat, and muscle get thinner as we get older. Understanding all that, it is certainly understandable how you went through this path.
As for scar tissue, it is something any doctor would be concerned about, and in my perspective as a surgeon, there is an advantage to a surgeon who does this type of surgery to understand the planes t involved when you are placing a filler when there is previous surgery. When we do a procedure called Structural Volumizing, we place the filler at a level comparable to where the cheek implant was placed between the bone and muscle. The filler fills the void or deficit necessary to create projection and give the person nice looking cheeks.
That said, although this is a technical aspect that may be relevant, and still doesn't mean that there hasn't been any changes anatomically from repeat surgeries, there is a layer over the bone called the periosteum. The periosteum is a very tight sheet is connected over the bone. When you place a facial implant, the periosteum is lifted away, and the implant is placed on the bone, then the periosteum is redraped. When you are placing filler, you are not going at that same level, so that could be the space which has the majority of the scar tissue. It’s possible the tissue above the periosteum may have a limited impact from the previous surgery. That doesn't mean the surgeon previously may have, as part of the procedure, crossed those boundaries as part of the process of surgery.
When I treat someone who has similar history, I can usually tell using instruments called blunt cannulas at the level between the muscle and the bone, that with reasonable certainty get a good result that respects those tissue planes. I think it’s something you have to figure out by doing. There are certain precautions that would probably be advisable when you have a consultation with the doctor.
Learn more about the technique of Structural Volumizing, and I think there is hope for you to achieve a look that’s comparable to having a facial implant but, still be more customized. The very nice thing about fillers is you can really customize the volume, placement, and the level. You can really mold it in a way like a sculptor so you can get a nice result that fits your face at various levels, and get a nice, natural look that can be pleasing and right for you, which are additional benefits of using fillers. I hope that was helpful, I wish you the best of luck, and thank you for your question.

Certainly scarring has the ability to be a hindrance dependent on the degree of scarring however enhancing volume with fillers and/or fat transfer should not be an issue.     Fat transfer may be an option but typically would require multiple stages.    Volume fillers such as Voluma and Bellafill would also be a good option to give more immediate volume enhancement.