Can I get away with one syringe of cheek filler to address my under-eye area or do I need a syringe there as well? (photo)

The number of syringes of a filler used on a patient may vary by injector.  The nice thing about using injectable fillers, is that you can always add more if desired.  Adding filler to the cheeks can help with the under eye area, so doing this is not unusual.  You could always start with 1 syringe of Voluma for the cheeks and 1 syringe of an under eye filler and then add more later if you wanted.  

Hello, it is typical to see volume loss by the mid 30s.  You may notice the under eye area the most because it makes a person look tired generally and “sad.”  It is the number one reason patients come in to the office.  But the answer is not always correcting that area first.  I would recommend you have your face evaluated from all angles.  Often I find the cheeks are sunken in esp when evaluated from the side angle.  As a result, there is downward sweeping affect of the mid face.  When I start correction either mid cheek or lateral, the full face looks more “awake” and less tried.  The tear trough may still require fillers but usually a minimal amount is needed.  I find that you will see positive affects with at least one syringe on each side, followed by a third for the tear trough area.  But it may still not be a full correction as 3 cc is not a lot.  It is just a little over a half a teaspoon.   You will have minimal correction with one and it may not even be noticeable.  So unless you think you’re ready to do multiple, I may hold off until you find you’re comfortable with someone enough to move forward withe the full correction.  Good luck.

Hi @Heaven0507! The upper cheek is a major support for the under eyes. I would first begin with addressing the volume loss in the cheeks followed by addressing the tear trough area. Best of luck, Dr. Nima!

Thank you for your question.I would recommend an in person consultation with a board certified PS. Injections around the eyes are tricky and the skin is very thin there. You want to make sure you are going to someone who knows the anatomy and has been trained to do these injections.

Hi and thank you for your question! While each patient is different and an in-person consultation and examination is needed, I frequently inject cheek filler together with filler under the eyes for a more uniform and natural-looking results. In many patients, injecting filler under the eyes without addressing the volume loss in cheeks will lead to unsatisfactory results. Regarding the number of syringe needed, as long as your injector is experienced and you have done your research to make sure she is the right one for you, you should trust her recommendation and going below the recommended number of syringes might not be the best approach. I hope it helps and good luck! 

Hi Heaven0507,I prefer to start with the eyes first before treating the cheeks. If the patient is happy with just the lower eyelid fillers, the cheek filler can be skipped.If the cheek is flat, after treating the lower eyelid area, there can be a transition or irregularity from the filled lower eyelid to the cheek area, which would benefit from filling the cheek area.The injector feels that you would likely benefit from cheek filler, but not every patient is the same.  To treat every patient using a cookie cutter algorithm will result in some unhappy patients, who feel that their cheeks look weird when they smile, or they feel like they have something stuck in their cheeks.Voluma (and Vollure) is notoriously difficult to dissolve, and can take many sessions of dissolving to wash it out.  In my practice I prefer Restylane Lyft or Defyne depending on what I'm trying to accomplish.  Restylane products are easy to dissolve, along with the original Juvederm XC and Ultra XC.  Another thing that I do when injecting patients is to put myself in their shoes.  I try to use the first syringe to create as much improvement as possible along with as much symmetry as possible.  This may not completely eliminate the problem, but if the patient wants to be conservative and only do one syringe their first time getting injections, at least they can leave the office improved and more symmetric.If I inject a full syringe in one of your cheeks first, and you don't like it, then am I going to inject only half syringe on the other side?  Now you may be stuck getting another full syringe on the other cheek, which you may also not like.  On top of that, I've already used up a syringe or two on the cheeks and you haven't seen an improvement in the area which you came in for, so you might start losing confidence in the injector.If I warn you first that you may need filler on the cheeks based on experience, but I am willing to treat you lower eyelid area first, then if I am right, you were forewarned that you may need cheek filler.  If this is the case, I would only open one syringe first and distribute that first syringe evenly between the two sides.  This give you an opportunity to stop at one extra syringe on the cheeks with 1/2 cc on each side.  If you want to stop, you can walk out looking normal.  If you really want more then I open another syringe for the cheeks, then we can of course do that, and you may end up getting the 3 syringes which the injector had recommended.Having said that, I don't think your lower eyelids are that bad, and you may like what 1-1.5 cc of Restylane will do for your lower eyelids, and if desired consider 1 cc of Restylane Lyft for the cheeks if it becomes obvious after filling the lower eyelids that the cheeks could benefit from some filler.In the example before and after I posted on the weblink, I used 1.5 cc of filler for the lower eyelids, but none on the cheeks.  Let me know what you think :)Hope that makes sense.Best,Dr. Yang

Facial sculpting and contouring can be created with well-placed fillers (Voluma, Radiesse, Bellafill) and Sculptra, which would give improvement in facial balance. Fat or implants are alternatives. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Thank you for sharing your question and photograph.  Based on your supplied image I would favor one syringe per cheek of Voluma followed by another syringe of a thinner product for the undereyes.  Hope this helps.

Most patients benefit from adding cheek volume when correcting the under eye area. This ensures the contours are harmonious. An in person evaluation is best but from the photo it appears that more than one syringe split between the two cheeks would be recommended.

Thank you for your question about cheek/under eye filler. I believe your nurse injector gave you a great recommendation. Before addressing under eye hollowness, the cheeks should be addressed. It will add a great lift to your face which will also help the under eyes. After this is addressed, we would recommend PRP to help build collagen under your eyes and then filler in that area as a last resort. Any cheek filler would be helpful but splitting one syringe may not give you the desired look. You will see much better results with one syringe of cheek filler on each side. Good luck!