what's the best cheek filler when you think of a
youthful face full and defined cheeks naturally
come to mind as you get older facial volume decreases
making the cheeks looking flatter and more aged
this is mostly caused by bone volume loss
as well as diminishing fat and soft tissue
cosmetic fillers are the most popular option to enhance
cheek volume stereotypically patients with conventionally placed cheek fillers
often appear overfilled doughy or pillowy
assuming that it's the type of filler used that makes these people
look unnatural i'm often asked what's the best
cheek filler in consultation i'm also asked
what is the best cheek filler by people who've had filler done prior
and felt the filler didn't last that long
i'll discuss different cheek filler options and what i do
to help my patients look defined and natural
and enjoy long-lasting results i'm Dr Amiya Prasad I'm a
Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic
and reconstructive surgeon I've been in practice in New York City
and Long Island for over 25 years i perform cosmetic filler treatments
every day in my practice using techniques to minimize bruising
which is particularly important in delicate areas
such as the lips or the upper and lower eyelids
i apply my knowledge as a surgeon to perform deep and precise placement of
hyaluronic acid filler for procedures such as non-surgical
rhinoplasty technique is critical to successful
filler placement for example i routinely apply a unique
approach to bone level placement in order to enhance
areas such as the cheeks jawline and chin for a more defined natural looking
appearance this is in contrast to conventional
techniques where filler is placed at the skin level
resulting in a less defined and more swollen appearance
during consultation for people considering fillers
they are often very concerned about looking bloated
or doughy characteristics seen in some celebrities or
shown in stories about cosmetic procedures gone wrong
for some people who've had previous cheek filler treatment
there is also frequent concern about the longevity of their results
in addition people who've had cheek filler in the past express
frustration with the variability in their results
and frequently experiencing bruising and swelling
afterwards as we're all aware there is heavy marketing of fillers
directly to the public so it's not unusual for people to ask
for a filler by brand name the other side of
this marketing approach is that many people blame their dissatisfaction
with their results on the brand name of the filler used
and actually less on the practitioner performing their procedure
so when people look for the best cheek filler
they first want to avoid looking bloated and doughy so they ask
what filler can best help them avoid this
unnatural appearance as stated technique is critical for optimal results
most doctors place cheek fillers just below the skin
at the fat and soft tissue level below the dermis
in practical terms placing filler to enhance cheekbone structure
at the fat and soft tissue level is limited because the tissue structure is
unable to maintain a shape that is intended beyond a small
volume of filler so instead of the cheeks looking
full and defined characteristic of a younger person
you end up looking soft and bloated since the soft tissue levels of the face
can't hold much filler the material migrates and spreads
beyond the cheekbone area making the face look rounded
so in order to avoid having a bloated looking face
it's not specifically the brand of filler
but rather the depth and technique of filler placement
that matters i place filler at the bone structural level
the bone structure is more stable platform for the filler to be positioned
in addition the material is held in place
by the muscle layer over the bone which prevents migration of the filler
material through this approach at the structural
level your cheeks look full and defined
not soft or doughy i refer to this method of filler placement as Structural
Volumizing which when performed in several other
areas of the face such as the chin and jaw angle at the
same time is referred to as the Y Lift
although placement of filler at the bone level is a
non-surgical procedure i apply my knowledge and experience as a
facelift surgeon and facial implant surgeon
to optimally place the filler at the proper
level a large proportion of injectors lack this surgical experience and make
assumptions about where they're placing fillers for
example they may feel that they're placing filler at the bone level
when they take the syringe and contact the bone
with the needle unfortunately this is not delivering much material to where
they think it's going i use blunt tipped cannulas
instead of needles and i'm able to glide through a space without
traumatizing blood vessels or other important anatomic structures this
reduces the chances of bruising and other
potential complications in order to understand how i select
fillers it's important to know the difference
between fillers and their optimal areas of use
in my opinion hyaluronic acid fillers are the gold standard when it comes to
filler options hyaluronic acid is naturally present in
the body in areas like the skin and the joints what further makes the
use of hyaluronic acid fillers appealing for me is that they can be
dissolved with an enzyme called hyaluronidase
this makes any procedure with hyaluronic acid
more easily reversible the body produces hyaluronidase
as part of the normal metabolic processes
related to your own naturally produced hyaluronic acid
this makes hyaluronic acid very biocompatible
manufacturers produce hyaluronic acid fillers with different viscosities
generally speaking the thicker the hyaluronic acid filler
the longer it lasts however thicker hyaluronic acid fillers are not
ideal for areas such as the lips the eyelid to the
forehead for areas such as the cheekbones i have
found thicker hyaluronic acid fillers such as
Juvederm Ultra Plus and Juvederm Voluma to be very effective with longevity
ranging from one to two years of course there are competing products
which are semi-permanent or permanent fillers these fillers which are often
made of material that are actually resistant
to the body's metabolic processes with these fillers there's a greater
risk for farm body reactions requiring medications and steroid injections
as well as the potential need for surgical removal
should these permanent and semi-permanent fillers get infected
they cannot be dissolved like hyaluronic acid fillers can
i strongly advise against semi-permanent or permanent fillers
although complications can occur with hyaluronic acid fillers
the biocompatibility and reversibility makes them in my opinion
superior to any other filler option Structural Volumizing of the cheekbones
is performed routinely in my exam room taking very little time with little to
no bruising or any significant swelling many of our
patients come in during their lunch hour making this a true lunchtime procedure
i routinely see my patients again after two weeks to see
how the filler material has settled and if any enhancement should be considered
as for any elective procedure safety is paramount
to enhance the cheeks the use of natural hyaluronic acid fillers combined
with precision placement techniques has been a
very effective approach for my patients i hope you found this information
helpful thank you for your question
you