Submalar Implants Vs Fillers for Improving Face Shape?

I am 45, female, thin and have always had a prominent chin, high lateral cheekbones and an average pointed nose. This gives me a crescent moon shape to my face viewed from the side. I'm not yet concerned with aging so much as the actual shape of my face.

I had a consult with a plastic surgeon who recommended filler as he isn't comfortable with Cheek implants. I currently have 6 syringes of Perlane in the sub-malar area. I really love the balance it has given my face, but I can't continue to inject SIX syringes every year! Advice?

Doctor Answers 5

Use fat grafting for cheek augmentation and volume correction. Avoid implants and strange off the shelf products!

You are the perfect candidate for fat grafting.  When done appropriately fat grafting can offer complete correction without added cost per volume and provide a lasting result.  I commonly place 60-80 mL of fat into faces such as yours with beautiful results.  This degree of correction would be cost prohibitive with fillers.  Most of my patients recieve HA treatment with Juvederm 1-3 times then convert to fat grafting to attain better results and end the spending cycle associated with temporary fillers.  Fat grafting has recieved a bad reputation mostly because practitioners kill the fat in their 'processing' with high g-force centrifuging, excessive handling etc.  Careful fat grafting does work and provides the most beautiful results.   Nothing looks more natural.  I hope this helps!


All the best,


Rian A. Maercks M.D.

Miami Physician
4.9 out of 5 stars 75 reviews

Sub-malar Implants vs Fillers

Over time the fillers will cost far more because of the need for repeated injections. Injections of your own fat will provide longer, sometimes permanent improvement. We have used submalar implants for reliable permanent correction with great success for many years.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Submalar implants provide long lasting results

A problem with placing dermal fillers into the cheek area is the cost. The fillers require so much volumetric material that it is just too cost-prohibitive and is temporary. The result is only going to last four to five months at best. These are dermal fillers and are not supposed to be used as facial fat fillers.

Other procedures that work quite well in the midface area are malar and submalar implants. Submalar implants are used when patients have high cheekbones that have lost soft tissue volume in the lower cheek area. Either one of these type of implants are placed through an intraoral incision above the teeth and are inserted underneath the periosteum of the maxilla, and are placed over the bone so that they are nonpalpable and look natural.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Cheek Implants versus Injections

In my opinion, cheek implants have been largely replaced by injectables. A cheek implant involves a surgical operation for placement of the permanent implant. Injections offer a temporary alternative which is non-invasive but give remarkable results. However, if you like the look of the fuller cheeks that you received with injections and know that you want a permanent "fix," then considering cheek implants is not a bad idea. You may also want to consider fat grafting the cheeks. The fat is harvested from your thighs or abdomen and then injected into your cheeks. The fat gives a very natural and often permanent change and can usually be completed in the office instead of the operating room. Good luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 77 reviews

Cheek Implants, Cheek Augmentation, Cheek Fillers

You may want to try Sculptra or Perlane to fill out the Cheeks and area just below them. The right cheek looks like you could a do a Cheek Implant however, the left side is a bit to full for one.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.