Fillers for the cheek area & migration...previous Dermalive Injections to NLF

Question

I’m 67 and unfortunately had Dermalive injections in the NLF & marionette lines about 20 years ago. Fortunately my nodules are not as extreme as some have had. I have lost volume in the cheek area but need to know what if any filler would be safe for me and not migrate to the Dermalive as this could prove catastrophic to me. Thank you.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing such detailed information—it really helps in understanding your situation. Given your history of Dermalive injections in the nasolabial folds and marionette lines from many years ago, your concerns about filler migration are completely valid. Older filler material can sometimes change the way new filler behaves, especially if there are nodules or areas of scarring from past treatments.

For the cheek area specifically, hyaluronic acid fillers are usually considered the safest option because they are reversible and tend to stay where they are placed when injected correctly. However, in someone with previous fillers, careful planning is key:

Assessment of old filler: It’s important to evaluate where any remaining Dermalive might be. Even if it’s not very noticeable, the presence of old filler could influence how new filler settles.

Choice of filler: Softer, highly cohesive HA fillers that are designed for deeper cheek volumization are often preferred. These tend to have less risk of migrating into old filler.

Injection technique: Placing the filler in the proper plane (typically deep to the muscle or on the bone) reduces the chance of it moving toward older filler in the folds or marionettes.

Avoiding complications: If any significant nodules or irregularities are present from past treatments, sometimes it’s necessary to consider dissolving small areas with hyaluronidase before adding new filler.

Overall, cheek volumization is possible and can be very natural-looking, but it requires a conservative, precise approach given your history. Migration can usually be minimized with careful filler selection and placement, and with modern techniques, the risk of “catastrophic” results is low when managed properly.

Your caution is wise, and being thoughtful about filler type, injection depth, and technique is exactly what keeps outcomes safe and beautiful.

Leonard Grossman, MD · Answer

There’s absolutely nothing that is safer as an injectable product than your own fat. You shouldn’t just focus on your cheeks or you will start looking just as funny as Madonna did when she had her cheeks filled out. You need to consider having your whole face brought  in to proper proportions that will make you look more youthful and just like the way you used to some 20 or 30 years or even more.  
When fat grafting to the face is done by an expert Plastic surgeon, who specializes in graft the results natural practically permanent. Hope this helps good luck, New York City, Plastic Surgery

Fillers for the cheek area & migration...previous Dermalive Injections to NLF

Answers (2)

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