CHEEK AUGMENTATION

Pros

• Implants can be custom-made to fit your anatomy, and you can choose to have only one, to balance asymmetries.
• They should look natural. “Cheek implants aren’t normally obvious if done with the correctly sized implant,” says San Francisco Facial plastic surgeon Dr. Michael Echavez in a RealSelf Q&A.
• Adding volume in the midface with cheek implants may slightly lift sagging jowls. 

Cons

• Cheek implant surgery is an invasive procedure that requires at least a week of downtime. You’d have two weeks of bruising and swelling after the procedure. Other possible side effects post-surgery include bruising, asymmetry, and infection.
• People who later choose implant removal may have some sagging in the midface, says Dr. Barry Eppley, a plastic surgeon in Carmel, Indiana, in a RealSelf Q&A. If this occurs, it can be treated with fat or injectable fillers.

Related: Can Cheek Fillers Really Lift the Face? Experts Weigh In on What to Actually Expect

Your cheek augmentation cost will depend on your provider's credentials and level of experience, as well as their practice location.

Other major factors include which type of procedure you choose, and whether it requires general anesthesia (which can add thousands to your bill) or can be performed under local anesthesia, or even simply with lidocaine.

For example, cheek implants cost about $6,000 more than injectable cheek fillers, on average. And while the results of cheek fillers typically last less than two years, this treatment option has a much higher Worth It Rating from reviewers on RealSelf.

An experienced plastic surgeon who offers a range of cheek augmentation options can recommend the best option for your goals and budget.

The cheek augmentation photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Cheek implants are the most permanent augmentation solution.

Dr. William Portuese, a facial plastic surgeon in Seattle, says that implants are “manufactured in a large array of thicknesses, sizes, and shapes.” Made of silicone, Medpor (porous polyethylene), Gortex, or hydroxyapatite (a substance much like tooth enamel and bone), implants can be inserted into different areas of the cheek.

Malar implants are placed on the cheekbones, whereas submalar implants are secured in the midcheek, to make your face look less gaunt. A combination of the two creates full facial volume. 

“In our practice, we place cheek implants under general anesthesia, as an outpatient procedure,” Dr. Portuese continues. “The implants themselves are inserted through an intraoral incision [aka through the mouth].”

A small incision is made just above the top of the gumline inside the mouth, and a pocket is created to slide the implant just over the bony surface of the cheekbone, under the skin. The incision is hidden, so you won't have visible scars.

Once the implant is positioned, it may be secured with a permanent screw. The whole procedure takes about one hour. 

You'll need up to a week of recovery time, though the recovery itself is relatively easy. Your surgeon can prescribe pain medication to help keep you more comfortable during the first few days of recovery.

You may have temporary facial numbness or lack of sensitivity, which can last up to three months as nerve endings heal. Most of the swelling and bruising will subside within two weeks.

Because you’ll have stitches in your mouth, you have to brush very carefully in order to not disrupt the gumline until the stitches dissolve. You’ll also be on a liquid diet for the first 24 hours, and you’ll have to avoid foods with hard or sharp edges for six to eight weeks after surgery. 

With your doctor’s permission, you should be able to return to work within a week. When the swelling fully subsides (which can take as long as six weeks), you’ll be able to see your full results.

Facial fat transfer, also known as fat grafting, is a minimally invasive surgical procedure. Your surgeon takes some of your own body fat from your hips, thighs, or stomach via liposuction and injects it into your midface to add or restore volume. 

“It’s great for someone who has facial deflation,” New York City–based plastic surgeon Dr. Steven Wallach explains in a RealSelf Q&A. “The procedure can be done usually in an hour or so. Because fat does not ‘take’ 100% of the time, some patients will need additional procedures to reach the full desired effect.” Not all transferred fat survives, but the fat cells that do survive should be permanent.

A cheek lift (or midface lift) isn’t as intense as a full facelift, but it’s still a surgical procedure that requires general anesthesia. Your surgeon lifts and repositions the skin, muscles, and fat pads of the cheeks during a two-hour surgery. You’ll have up to 10 days of downtime. 

Injectable fillers aren’t permanent, but they can add volume to the cheek area quickly, at less expense than cosmetic surgery, with natural-looking results. They do require maintenance appointments, if you want to keep your results. Popular dermal fillers that can give you fuller cheeks and define your cheekbones include:

• Juvéderm Voluma XC, a hyaluronic acid–based filler that lifts and contours cheeks for up to two years
• Restylane Lyft, also a hyaluronic acid–based filler that augments cheeks for up to 12 months
• Radiesse, made of microspheres of calcium hydroxylapatite (CaHA), which can last up to a year (sometimes longer, because it stimulates collagen production)
• Sculptra, a poly-L-lactic acid (PLLA) filler, which also stimulates collagen production, replacing lost facial volume for up to three years

RealSelf Tip: Cheek enhancement procedures can be safely combined with other plastic surgery procedures like chin augmentation or a rhinoplasty, to help balance your facial features.