Sunken Cheeks: Long-lasting Dermal Fillers Available?

You sound like a perfect Sculptra candidate.
Fillers do go away in months and if you need considerable "plumping" the cost of repeating temporary fillers can get very high.
Sculptra was originally approved in the US for treating lipo atrophy in patients with HIV over 5 years ago. Lipo atrophy (or fat wasting) is not a problem only for those with immune deficiency, but also for some with high metabolism, from weight loss, or just genetics predisposition.
Sculptra is injected in such a way to restore volume in nearly any area of the face. Done well, you can fill out the central face, cheek areas, temples and the fill effect from above can "lift" the jowls.
The volumizing effect comes from your own collagen since Sculptra's job is to activate new collagen production. Obviously your own collagen will be less prone to breakdown than a gel filler. Many patients enjoy prolonged volume improvements of 2 years or more....this is all dependent upon your own body's system and health, but you should certainly expect a good 18 months.
I was fortunate to begin working with Sculptra while it was being investigated years ago. My patients in the Los Angeles clinic were thrilled to "get their face back". The work and research opportunities I've had led to my becoming a trainer for Sculptra and I love seeing what it can do for such a wide variety of people.

Thank you for your question. For long-lasting facial volume, your options are facial fat grafting or a collagen stimulator like Sculptra. Facial fat transfer takes small amounts of fat from another area of the body and injects it into the face to create the volume you want. You mention you are not a candidate for fat transfer, so if this is really the case, Sculptra might be your best bet. This collagen stimulator is injected deep into the dermal tissue, where it triggers the body to produce more collagen. As collagen levels rise, the midface becomes fuller and more defined naturally. It can take a few months for the results of Sculptra to fully develop, but improvements can last two years or more. I recommend scheduling a consultation with an experienced, board-certified facial plastic surgeon who can assess you in person and create a customized treatment plan to meet your needs and goals best.

Hollow or sunken cheeks are difficult as the filler needs to be both high volume and smooth.  Sculptra will stimulate collagen over time and is excellent for this application 

When it comes to long-lasting fillers for the cheek area we have found Sculptura and Voluma to be our products of choice. Sculptura works by stimulation of a new collagen formation and it can last longer than even two years. Voluma is a hyaluronic acid filler, the longest lasting one and particularly good for deep fillings such as cheek bone and jawline which lasts between 18 to 24 months.

Dear HongKong,Sculptra is a great long lasting filler that works very well in the cheek area Results can last 2 years with SculptraAs far as filling the cheeks to lift the nasolabial folds, that just depends on your exam, you do get some lift, but you also do not want to look too puffyBest regards,

Dr. Nima

Member, American Academy of Facial Plastic and Reconstructive Surgery

Board Certified Facial Plastic Surgeon

Board Certified in Head and Neck Surgery

 

Hi there!
There are a number of approaches available, I will list them from least to most involved/expensive. Voluma is a hyaluronic acid filler that lasts about two years. It is relatively inexpensive, and only takes a couple visits to achieve a good result. Cost is between $2-3 K depending on the patient. It has the advantage of being reversible with an injection if you don't like the result. Sculptra achieves a longer lasting result, causing deposition of collagen in response to the product. This product is difficult to reverse. The final and most expensive option is fat grafting.  If successful, the result is permanent. There is downtime due to swelling/bruising that lasts a couple weeks, and if your weight fluctuates, the fat will shrink/swell in response. I hope this helps!
Matthew. C. Camp M.D
Board Certified Plastic Surgeon

There are numerous options to treat deficiencies of the soft tissues of the cheeks. Many fillers can last longer in the cheek area than Restylane or Perlane.  Voluma in some patients can last longer, with many patients reporting up to 2 years of improvement.  Another great option is Sculptra, which relies on your body to produce its own collagen in response to the product. 
There are other permanent or semi-permanent fillers, but I do not typically recommend these products. Fat grafting can also be successful for long-lasting results, but is somewhat unpredictable. Finally, cheek implants are a great option.  These implants are very predictable, immediate, stable, and permanent.

Don't worry! There is hope!I like to start with Juvederm to make sure that the patient likes my aesthetic sense before I do something more permanent.Once we have established that we are on the same wavelength, I like fat transfer for a natural, youthful result. With that said, sometimes women not only need more fill in their face, but a lift as well. If you are nearing 50, it may be that time. But it would be difficult to say without seeing you in person. Consult with a board certified plastic surgeon to explore your options. Good luck on your journey!

One has to understand the aging process of the mid face in order to correct the sagging that you see in your cheeks.  This sagging also is the cause for the deepening of the parenthesis (nasolabial folds).  All to often, plastics surgeon go after these folds, filling and unnaturally effacing what we were born with.  They are treating the symptom, not the cause- the loss of cheek volume.  I have patients bring in photos from their 20's and 30's to demonstrate this change in facial volume which can involve the cheeks, under the eyes, temples, and jaw line.There are many options for restoring youthful volume to the cheeks.  If you are looking for instant results, that can last 6 to 12 months, usually a combination treatment of Radiesse, Juvederm, and Restylane injections work the best.  Many patients want longer lasting results, that are instant, without downtime.  The safest product, is Juvederm Voluma, which can last up to two years.  It is the only FDA approved injectable filler for the cheeks.  Many patients opt for Sculptra injections because the results develop gradually over time, are natural, and last more than two years.  Surgery is always an option, including fat injections and cheek implants.  There is up to two weeks of downtime but when performed well, these results are also very rewarding.

Thank you for the great question. For patients with severely sunken in cheeks or a lot of volume loss, a great "filler" option is Sculptra. This works differently than the other fillers -- rather than just adding volume as it is injected, Sculptra promotes collagen growth where it is injected.  The treatment requires a bit more patience -- usually 2 or 3 sessions are needed and the full results aren't seen for a couple months.  However, it can be a great, natural-appearing result that lasts 18-24 months!

Fat transfer is an excellent option for long term correction of sunken cheeks and a great alternative to temporary fillers like Restylane, Jeuvederm and Sculptra. 

Fat Transfer Results Are Long Lasting

 

Fat Cells that survive the transfer process continue to live like other fat cells. Therfore the results are long lasting. The problem is not all transferred fat survives the process. In the face more than 75% may survive and more than 60% in the buttocks.. Of most interest is that the fat that does survive behaves as if it was still in the donor site. Therefore as the surrounding native fat tends to atrophy the transferred fat will not. Over time you will notice that the area may not be as full as it once was, but more than likely it is because of the native fat atrophy rather than the transferred fat.

 

Fat Grafting Results Permanent improvement in most cases. Micro fat grafting, also called structural fat grafting involves multiple injections of very small amounts  of fat injected in a series of discrete layers to allow for better revascularization and "take", gradually increasing the volume of  new soft tissue. My experience is that it is a great minimally invasive procedure for cheek augmentation.

 

Fat Cells that survive this transfer process continue to live like other fat cells. Therefore the results are long lasting. The problem is not all transferred fat survives the process. In the face for example it has been estimated that up to 60%  or more will survive in the cheek region. Of most interest is that the fat that does survive behaves as if it was still in the donor site. Therefore as the surrounding native fat tends to atrophy the transferred fat will not. Over time you will notice that the area may not be as full as it once was, but more than likely it is because of the native fat atrophy rather than the transferred fat.