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,
