Is there a way to get rid of a cheek crease? Filler seems to have made it worse (Photos)

Question

As the title says. I got filler but it seems to have made the crease worse. Is there anything else that would work to get rid of that crease?

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question and posting your photos. Since the fillers are already in your cheeks the issues are difficult to evaluate. See an experienced oculofacial surgeon who can dissolve the filler and give proper guidance. 
Good luck!

Nelson Lee Novick, MD · Answer

At least from the photos provided, it would appear that the use of a low viscosity, malleable, cohesive HA filler expertly injected in the depression would create the desirable smooth transition between the two areas of the cheek. 
When it comes to the use of the various, expensive energy-based gizmos, such as fraxels and RF devices that may be hawked to you, you would be wise to exercise a healthy amount of buyer beware, since the hard science behind these "bells and whistles" lags woefully behind the heavy marketing and social media buzz to promote them. 
Microneedling, which I have  been performing for nearly a quarter of a century is best reserved for very superficial surface textural and/or color Irregularities; it is unlikely to be of much value here. 
I would also be reluctant to dissolve the filler currently there with hyaluronidase (assuming even that it was a hyaluronic acid-based filler), as this might also affect the normal hyaluronic acid as well and might cause some unwanted sagging and crinkling. 
You would be wise to consult with an experienced, board certified cosmetic dermatology filler expert. 
Hope this helps and best of luck.

Anna Chacon, MD, FAAD · Answer

Certainly, if you're unhappy with the results of a filler treatment, there are a few options you might consider:

1. Hyaluronidase: If your fillers are hyaluronic acid-based (like Juvederm or Restylane), they can be dissolved with an enzyme called hyaluronidase. This will break down the filler and your body will naturally eliminate it.

2. Additional filler: In some cases, a skilled injector may be able to place additional filler around the crease to smooth out the area.

3. Laser treatments: Certain types of laser treatments can stimulate collagen production and help to smooth out the skin.

4. RF Microneedling: Radiofrequency microneedling is a non-surgical treatment that uses tiny needles to deliver radiofrequency energy into your skin, stimulating collagen and elastin production and possibly reducing the appearance of the crease.

5. Facial exercises: Some people find that certain facial exercises can help to reduce the appearance of wrinkles and creases.

6. Skincare products: Some over-the-counter skincare products can help to reduce the appearance of wrinkles and creases.

It's important to consult with a board-certified dermatologist or plastic surgeon to discuss these options and decide on the best course of action for your specific situation. Please note that results may vary and it may take some time to achieve the desired outcome.

Darryl J. Blinski, MD · Answer

Based on your post Photos. I would recommend a minor surgical procedure of sub scission of the dermal bands to the subcutaneous tissue with an addition of nano crafting and sculpture injections. Fee $10,000. Best of virtual consult

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