How can I fill out my face to balance a large jaw?
Fat transfer is a very good, long lasting way to augment the cheeks, lips, jaw line and other areas to balance a large lower jaw. Fillers will work, but it may take a lot of filler to create good balance. Fat may be less expensive and longer lasting. Cheek implants can be placed if desired after fat transfer or fillers have partially or completely disappeared.
I like facial fillers such as perlane or juvederm for the cheeks. I have used fat grafts as well with success. This should not preclude you from having cheek implant although you may not need them.
Fillers can help -- in my experience, Radiesse lasts longer than the HAs. For cheeks, if you put it deep, it seems to last longer. Cheek implants can be done after fillers.
Fillers and Cheek Implants
Injectable fillers are now done much more frequently than we do cheek implants - and yes, cheek implants can be done later. The important thing is not to have a permanent filler, but the longest lasting injectable agents for correction of the mid-face are Voluma and Sculptra. Both of these can last two or more years, and as your face ages we put more where you need it. Cheek implants can be used later. Voluma can be dissolved and will not affect the ability to put in cheek implants later. Cheek implants often do not look natural after many years because as the face changes, they may need to be removed or replace. Therefore, many people either get filler around cheek implants or simply defer cheek implants instead and get injectable fillers such as Radiesse, Voluma, or Sculptra.
Nonsurgical Cheek Augmentation With Volumizing Fillers Works Well For Flat, Recessed Cheekbones
Nonsurgical cheek augmentation using injectable volumizing fillers can be extremely helpful for restoring shape and balance to the face. In my Upper East Side Manhattan office, I would use a combination of Radiesse and Voluma XC tor this purpose. In my satellite Israel office, where a greater number of regulatory agency injectables are available, I would opt for Radiesse combined with Stylage XXL, and if greater lift and projection were required directly over the cheekbones, Restylane SQ.
I am not a fan of fat injections, since often the fat transplanted, despite the assertions of its proponents to the contrary, does not last much longer than the off-the-shelf products. Moreover, microlipoinjection requires a two step operative procedure consisting of the removal of fat from the belly, buttocks or thighs and reinjection with large bore cannulas into the face following a material processing step. And, finally, because the fat comes from areas that are subject to enlargement via weight gain, the transplanted fat possesses the risk that with the passage of time, the treated areas of the face, as a result of the weight gain changes that occur with aging, may begin to appear overly puffy and swollen.
The other products noted earlier are all natural materials and subject to the body's metabolic processes, so each will be broken down and metabolized in time, making permanent surgical implants entirely possible going forward, if so desired. However, given the ease with which periodic maintenance touch ups may be performed every couple of years with injectables, this approach would continue to remain a viable alternative to surgical implants.
Fillers are great treatment options to a more invasive implant surgery. Fillers used in the area are commonly Radiesse and Perlane (which is in the same family as Restylane). Radiesse lasts longer and can actually stimulate new collagen growth. Neither should preclude you from implants as an option in the future.