What Will the Future Look Like? Ever-larger Cheek Implants/fillers?

I'm in my mid-forties and have some fat loss under eyes & tear trough, indentations on sides of chin, sag, etc. I'm thinking about the future. In the short term, I'll probably do fillers or fat grafts, etc. But as I see images of celebrities looking stranger with giant cheeks to look younger (Madonna, etc), I'm thinking, why is it happening? Does it just take that much filler to look younger, as you age? Is it a matter of either (1) getting ever more fillers/implants, or else (2) looking old?

Doctor Answers 4

Restoring Lost Volume with Volumizing Fillers Is Crucial For Proper and Natural-Looking Facial Rejuvenation

It has only been in the past ten to fifteen years that we have had what might be described as a revolution in our thinking about what happens to our faces (and necks and hands, for that matter) as we age. Whereas once we thought that everything related to combined effects of gravity and skin laxity (looseness), which led to aggressive, invasive plastic surgery procedures (i.e. facelifts, necklifts, and blepharoplasties) to pull skin tight and cut off excess skin, today we more correctly understand that much of the aging we see arises from the loss of volume underneath the skin, i.e. loss of bone, loss of cartilage, and loss of fat. 

So, when we see with the passage ot time a nose drooping, where once it was upright and straight, we know it's because of a loss of supporting cartilage underneath the tip. If we see jowls along the jawline, or pronounced smile lines and marionette lines, we appreciate that there has been loss of cheek fat and a displacement downward of the remnants of the cheek fat pads that are at the root cause of these problems. When we sigh at the development of bags, dark circles, tear troughs and hollows under the eyes, we can appreciate that they have come about by the vacuum left as the heart-shaped, robust fat pad that once inflated that area has shrunken and shriveled and gone Southward and inward leaving the skin resting on the bone of the lower portion of the orbit of the eye and reflecting the dark underlying blood vessels and musculature in the region. And when we compare the face of a young Gregory Peck with that of the actor at a more advanced age, we realize that these changes in face shape, width, etc.,are due to underlying bony changes and reorganization.

If we have a favorite armchair that loses its tufting with time, do we send it off to the upholsterer and expect that the upholsterer will simply pull the remaining fabric taut and trim off the edges so that we end up sitting with our derrieres right on the wooden frame. Insead, we expect him to replace the lost stuffing. But that's not what surgeons routinely did to their patients in the past. They pulled the skin tight over the underlying bone and trimmed off the excess leaving their patients smooth, but looking like skeletons or cadavers or to use the words of one prominent NY plastic surgeon, "deformed." The famous comedienne Phyllis Diller used to poke fun about her freakish post facelift look.

It's taken us a long time, but we now know that restoring volume to the face (and to other deflated areas like the hands, etc.) is the essence of rejuvenation. It's not enough to tinker with the house. We need to fix the aging and shrinking foundation.

Fortunately, we have a whole variety of regulatory agency-approved volumizing fillers, like Radiesse in the U.S. and many others in other places, like Europe, Canada and Israel (Stylage XXL, Restylane SQ, Juvederm Voluma) that allow experienced aesthetic physicians to inject the precise amounts in the exact locations to quickly and easily (in minutes) restore more youthful facial contours without the need for scalpels or stitches and surgical scars. What's more, as a person ages, the exact placement of the materials and the quantities can be modified and tailored to precisely fit the aesthetic needs of the moment. Something that also cannot be as easily achieved with the surgical use of fixed- sized permanent implants. 

Of course, it should go without saying, that consultation with a board certified aesthetic physician with extensive experience with all forms of injectable volumizing fillers is a must for achieving truly natural and gratifying results.

New York Dermatologic Surgeon
4.9 out of 5 stars 30 reviews

What Will the Future Look Like? Ever-larger Cheek Implants/fillers?

 What you are describing is the lack of understanding of the aesthetic principles of facial beauty.  This is something that is not taught during plastic and cosmetic surgery training...yet it provides the means to make patients more youthful in a naturally attractive manner.  Are these aesthetic principles violated?  Absolutely and when you see the types of results that you describe, you are witnessing that event.  In today's over-crowded plastic and cosmetic surgery market, the burden falls on the consumer to select his/her plastic and cosmetic surgeon based on their understanding and ability to follow the proper aesthic principles for the creation of a naturally more attractive face.

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

Natural Results when Reversing the Physical Signs of Aging

Whether using fillers, implants, or facial lifts to reverse the physical signs of the aging process the results should always look natural. We all continue to age so you' re smart to consider the future when making decisions today. Always look at the results of surgeons you're considering.

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

What Will the Future Look Like? Ever-larger Cheek Implants/fillers?

The overly full cheeks are the result of clumsy and excessive filler use. This should not be the goal. It is possible to create subtle and aesthetic improvement in facial shape and volume without creating Madonna type cheeks. The goal is to create improvement that does not reveal either the presence of surgery or injectable fillers. This can be achieved through careful planning and meticulous execution of the proper procedures whether they be surgical or non-surgical. Cheek implants and dermal fillers tend to be the best options for midface rejuvenation and are often performed along with resurfacing procedures or facial rejuvenation surgery. I hope this information is helpful.

Stephen Weber MD, FACS

Weber Facial Plastic Surgery

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 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.