What do you recommend as the softest, most supportive filler for mid upper cheek region?

Hi nlgpa,I think there are enough RealSelf answers which help to tell the benefits of procedures, but not enough give the risks and drawbacks of the procedure in the answers.  I suspect the RS members researching their procedure of interest to prevent any “buyers remorse” and wasted money.  Only giving benefits “sugarcoats” the procedure thinking it can only be good, or it is better than all other procedures.  I will give a lengthier response to give some more insight into your specific area of concern. When injectors inject filler in the mid to upper cheekbone area, we are placing the filler directly on the bone like a mini cheek implant. Each little injection of filler on the bone is like a tiny chocolate chip sitting on the bone. Multiple injections placing these gel implants on the cheekbone will create a customized cheek implant. Injecting this area shouldn’t give a chipmunk cheeks look as submalar filling *might* do. People with too much buccal fat (baby cheek fat) will complain of chipmunk cheeks which is a heavy lower cheek.  Keeping the filler high should prevent the chipmunk cheek. However, depending on the patient if their eyes are hollow and they have hollows under the cheekbone, placing mid-upper cheek filler can make them look even more bony depending on the amount of filler and location of placement. The cheekbones will be more prominent, but that could make the hollow eyes even more hollow and the cheekbone hollows even more hollow. Upper-mid cheek filler looks great when not smiling; however, since the filler is not actually your cheekbone, it still adds volume to the cheek fat pad in this area which can push up towards your eyes when you smile. This is not a chipmunk cheek look, but not necessarily flattering either.  I will use younger photos to help figure out where best to replace or restore cheek volume. On my before photos for all injectable fillers, I have not only a relaxed face photo, but also a smiling photo for comparison.  The observations I’m stating here is based on my own observations reviewing these before and after photos (smiling and non-smiling) as well as feedback from my patients on follow up visits.  To kee my patients looking natural, only comparing non-smiling photos is not enough. The feedback from patients and then looking at the photo shoot will detect any weird bunching, bulges or lumps.  I also take a photo of my filler markings for future reference.  If certain filler injection locations are problematic based on feedback, I make adjustments on my technique, locatio and amount injected. “What gets measured, gets managed”I can tell you that I’m a great golfer, but if I’ve never kept score or statistics on my fairways hit, GIR, up and down %, or number of putts,  how good could I really get?  I may think I get up and down a lot based on my memory, but numbers don’t lie.  I use patient feedback and resting and dynamic photos to “keep score” and strive to be better every day.  Also, I think it is important to be humble and know that patient observations are important, and realize that many of my improvements in my injection techniques was based on things that patients didn’t love about the filling session. Luckily using Hyaluronic Acid fillers like Restylane/Juvederm brand fillers are reversible with an enzyme to wash it out or reduce the filler. Fillers like Bellafill or Radiesse are not reversible. If you are worried about not liking the filler please stay with Restylane brand products which are easier to dissolve.  Juvederm Voluma and Vollure is harder to dissolve. In fact, a dermatologist told me that she performed a non-surgical rhinoplasty using Vollure on her own daughter.   Months later they were considering a surgical rhinoplasty and the surgeon asked to have it dissolved before having the consult.  It took many sessions to dissolve the Vollure which is similar to our observations with Voluma. They shared the same cross-linking technology which makes the filler last longer, but also makes it harder to dissolve if needed.  Restylane brand doesn’t last as long but is much easier to dissolve if needed. I hope that helps. In general, I think the huge majority of patients are very happy with their procedures, but certainly there are patient may come back with feedback that they don’t love their filler when they smile or they  feel “chipmunk-ish” or too bony or too cheeky after filler. Listening to those comments and feedback and making adjustments to technique and location should increase the satisfaction rating even higher. #improveeverydayGood luck on your cheek filling journey. Thanks for the question.Best,
Dr. Yang
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Hi @nlgpa! Restylane Lyft, Restylane Contour, and Juvederm Voluma all look great in the cheeks! I recommend seeking treatments from expert injectors who have the skill and experience to precisely inject fillers into treatment areas and avoid risks and complications. Best of luck, Dr. Nima!

The stackability of the various cross linked hyaluronic acid fillers is well described. For facial upper cheek filling to obtain a natural look while smiling and at rest, I love the effects of Restylane  Lyft. While I used to utilize Juviderm everywhere, there are agents that have physical characteristics making them more appropriate in various places. It is for that reason that I have a host of fillers and different molecules- as each person has different priorities. Your best advice is find a master injector that is a board certified plastic surgeon. 

Thank you for your question. Juvederm is my filler of choices and there are many varieties of Juvederm. Schedule a consultation with an experienced injector to find out which product is best for you. 

Thanks for your question.  Every one is different and depends on your exact anatomy.  I do like Voluma to inject into the cheek region for lifting and filling in general.  Radiesse , however has a greater G-prime (ie, lifting power) and when injected directly near the cheek bone and give great lifting and softness due to overlying soft tissues.  The most important thing is to find an experienced injector that you trust.  Bes!

I like Restylane Lyft to give more 'lift' and support to the cheek but for better feathering and covering a larger area of the cheek I like Sculptra. I use both together at times. RegardsDr. J

Thanks for the question.  You will get many different answers here as the choice of filler really depends on the hands of the practitioner and their experience.  I would first choose the most suitably qualified doctor and then be guided by their recommendations after an in person consultation.  In my experience, the following are excellent cheek fillers when performed with the correct technique: Juvederm Vollure, Juvederm Voluma, Restylane Lyft.  I hope this helps.

All fillers are considered soft, but individual preferences will vary. The cheek is a broad region and many options exist for nonsurgical treatment with filler. Voluma, Juvederm, Sculptra, Restylane, etc are just some of the "liquid lift" treatments. The volume of material and location injected generally plays more of role on appearance than the material itself. Speaking with a plastic surgeon who focuses on the face can help determine appropriate options. Read more in blog link below.potomacplasticsurgery.com/blog/lifting-the-cheeks-with-fillers-for-balanced-cheeks/Best.Dr. Chaboki

I prefer to use Restylane Lyft or Sculptra when treating volume loss in the midface. I believe the goal should always be a natural looking and believable result and this can be achieved with these 2 fillers in the right hands. 

Hey there thanks for the question. The fillers that work best in these areas are the ones which are less likely to be compressed and flow around. These include Voluma, and Restylane Lyft.
I would recommend an experienced injector however as there is either a small potential for lump formation or no enough lift if pressed down too much. Done correctly there shouldn't be any 'chipmunk' appearance.