Thank you for your question.
You submitted a single photo and you are stating it in your question that you want to know
what kind of filler should you use to get a natural looking cheekbone and you go on
to saying that you like to develop this natural-looking cheekbone but you want to avoid scaring anyone.
Well, I can certainly understand your concerns.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I’ve been in practice in Manhattan and Long Island for over 20 years and I am very familiar
with and I use the wide range of fillers everyday in my practice and so I can certainly understand
your concern about not scaring anyone and I will show you my approach to helping people
achieve cheekbones.
To further elaborate on the fear of scaring people, I think that one of the things that
our patients have become extremely sensitive to is the fear that they’re going to look
like they’re bloated or they will have these round apples in their cheeks and they see
some famous people or my patients will ask me, “These people are so famous and so rich,
how come they end up looking this way?”
Well, certainly I can’t comment on why and how they ended up exactly looking that way
other than maybe some combination of their perception of looking good and their doctor’s
perception of them looking good.
But to go further into detail of the approach to cheekbone enhancement, I will explain to
you a little bit about the anatomy that’s relevant and that’s important.
When you look at a face and you define a face that is youthful and attractive, there is
something called the golden ratio which is essentially, regardless of ethnicity, it’s
almost a universal ratio of beauty, of attractiveness and basically it is a 1.6 to 1 ratio between
the upper part of the face, the lower part of the face at different points.
Basically, the cheekbones looking a little bit wider than the lower part of the face
creates this nice angularity where people describe often as like a model look.
Well the cheekbone itself is not just one area.
It represents an area that starts in the front and goes all the way back to the ear.
So when I look at someone like yourself and I want to see what is the optimal point, it
is a discussion we have in consultation where I’ll show you exactly and I will draw on
the area to show what the area that I would probably enhance or I would aim to enhance
so that you and I are on the same page.
But there is one concept that I think would really be invaluable in this approach and
avoiding looking like you will scare someone and that is the level of the tissue that this
cheekbone enhancement is performed.
I will explain further.
Essentially, the standard approach to enhancing the cheekbone area or to create cheekbone
is to place the filler in the soft tissue or just below the skin and that is perfectly
fine for a lot of people but I feel like that doesn’t really give you as good definition
as what we do in our practice which is called structural volumizing.
Structure meaning the bone structure is really what is defining the cheekbone.
We refer to it as a cheekbone.
And so, when I place fillers to enhance cheekbone, I place it at the cheekbone level below the
muscle, well below the skin.
So there is skin, a little bit of fat then there is muscle and then there is the bone.
I place it at this level and it creates this nice enhancement and more of a well-defined
appearance that really creates nice looking cheekbones.
And so I think that it’s certainly achievable.
Now as far as the choice of fillers is concerned, we again live in a time where we have very
good options.
We have longer lasting, thicker fillers such as Juvederm Ultra Plus or Juvederm Voluma
which has a viscosity, has a strength to it that can allow for this sculpting and molding
and can last for more than a year and technically can last, like Juvederm Voluma, can last up
to 2 years.
So there’s the choice of filler and then there is the method of placement and very
importantly is the style and the artistry of placement.
And so, I think certainly it is achievable.
I think, again, this is without a physical examination and I have to see how much elasticity
of tissue there is but I think you will do well with structural volumizing to get that
subtle but natural look that certainly won’t scare anyone by doing structural volumizing.
And that’s my opinion and from experience, I think that would work out well for you.
Using a long lasting filler such as Juvederm Voluma would also be my filler of choice at
this time.
So I hope that was helpful, I wish you the best of luck and thank you for your question.