Cheekbone filler looks great in repose, but distorts the apples of my cheeks when I smile. Can you recommend a solution?

I naturally have flat cheekbones and excess fat in the apples of my cheeks. Facial fillers (various HAs) have given me cheekbones that look lovely when I'm not smiling. However, when I smile, my cheeks appear overly full. Are there any techniques or alternative procedures that would allow me to keep the cheekbones without distorting my cheeks when I smile?

Doctor Answers 5

Filler in Cheeks

Great question, I think when you are having fillers injected into the face you need to evaluate the face at rest and in motion (smiling, laughing, talking). The amount of fillers that are placed in a face may vary depending on your facial expressions and the look you are trying to achieve all around. I think its a balance. I would recommend seeing a board certified physician who will evaluate you in person. A picture would also be helpful of you at rest and one of you smiling. Hope this helps.


Philadelphia Oculoplastic Surgeon
5.0 out of 5 stars 26 reviews

Facial fillers (various HAs) have given me cheekbones that look lovely when not smiling but cheeks too full when smiling.

 Hi, non smiling photos of your face from the front and side would help with the evaluation. I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin), liposuction and/or facelifts for over 30 years. Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces. Heart shaped faces have cheeks that are full and round in the front. Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.

 From your description, I suspect that there is excess fat below and in front of the flat area of your cheeks that is brought back up on the cheeks with smiling making them look too full and large.  Liposuction to reduce the excess fat combined with precise placement of an HA dermal filler to the front of the cheeks or cheek implants for a permanent enhancement might be considered.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Overly Full--Facial fillers (Voluma, Radiesse, Perlane, Bellafill)​: Sculptra, implants or fat for cheek augmentation

This is difficult to answer without a picture. In addition to fillers (Voluma, Radiesse, Perlane, Bellafill): Sculptra, implants or fat can be used for cheek augmentation. It may be an adjustment needs to be made to the amount injected or a different technique would give you better results. I recommend getting a formal consultation with a facial contouring expert. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Proper Facial Volumizing With Fillers Should Take Into Account Contours At-Rest & In-Motion

I have been performing facial volumizing using injectable fillers for many years. Experienced aesthetic physicians typically take into consideration not only how the person looks at rest, but how they look when they smile or otherwise emote. This is why when I evaluate patients I not only do so when their faces are at rest, but also at full smile, so that I can better adjust how much filler to inject and precisely where to inject it for best effect. I recently treated a patient with a situation just as yours treated by another physician. In this particular case, the patient opted for me to reduce the apple cheek look somewhat upon smiling with hyauronidase.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 23 reviews

Cheekbone Filler

The type of filler and where it is injected is the most important factor in achieving a natural and youthful result.  Are you able to provide a photo?  Consider a consultation with an experienced injector to review your concerns and goals.  Good luck!

Samuel Baharestani, MD
Long Island Oculoplastic Surgeon
4.8 out of 5 stars 24 reviews

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