The appearance of cheek bone definition is a highly desirable characteristic of models and actors. Many people desire more defined cheeks, whether their appearance is due to genetics, or bone and soft tissue loss associated with facial aging. I’ll talk about how I help my patients every day decide between options like cheek fillers, fat grafting, and cheek implants.
Throughout my career, I’ve performed a wide range of facial cosmetic procedures, including facelifts, cosmetic and reconstructive upper and lower blepharoplasty, fat grafting for facial volume correction, and facial implant surgery, including cheek implants, chin implants, and tear trough implants.
I’ve continued to refine my approach to assisting my patients with cheek volume enhancement, focusing on a few key points that are universally important to everyone I see in consultation, as follows:
- Safety
- Predictability
- Convenience
- Rapid recovery
- Longevity
This led to applying knowledge and experience in facial anatomy, and facial cosmetic surgery with new techniques such as The Y Lift in applying longer lasting hyaluronic acid fillers at deeper levels such as the space between the bones and muscles. Deeper placement of filler is also referred to as Structural Volumizing, which has made a significant impact on how I counsel my patients.
Cheek Implants - Recovery and Risks
Long-term procedures, such as the placement of facial implants, have always been appealing. Cheek implant surgery entails inserting silicone implants from the inside of the mouth over various aspects of the cheekbone.
Recovery
Patients require approximately one week to recover from the surgery, which I perform under local anesthesia with LITE IV sedation. Swelling can be more severe at times, and can take months to resolve.
Risks
Certain complications arise after patients have cheek implant surgery. Sometimes the appearance isn’t quite what the patient expected, which may necessitate the removal of the implants, requiring another surgical procedure. If the desired appearance can be achieved with additional filler placement, the patient may be conflicted about having a quote “permanent solution” and still needing filler placement.
Many people strive for maximum symmetry. Although facial implants can be customized to try to achieve this, achieving maximum potential symmetry is difficult until full healing has occurred. The fact that facial volume changes with age is an important factor that most people do not realize until it is explained to them. This means that bone loss, fat loss, and skin thinning will have an effect on the long-term results.
While I do perform cheek implants, often in conjunction with another surgical procedure such as a facelift, I inform patients prior to the procedure so they are aware of the limitations of facial implants.
Facial Fat Grafting - Why it's Not Recommended
In my opinion, fat grafting for cheek volume is not ideal for achieving the look of defined cheekbones. Unpredictability limits fat grafting, with 30 to 70% of fat placed disappearing through metabolization soon after the procedure. Prolonged swelling, with a high likelihood of asymmetry, are issues I would advise my patients to avoid in order to have a more predictable recovery.
Long-lasting hyaluronic fillers such as Juvederm Ultra Plus, and Juvederm Voluma are my preferred volume correction procedures for the face. While these fillers are widely available to aesthetic physicians, experience and technique are more important than the material used.
Cheek Fillers: Results, Convenience, and Longevity
Why Fillers Migration Happen
Injectable Fillers Using Structural Volumizing
Structural Volumizing is the technique I use. This method is derived from the same principle as surgical facial implant placement, except that the space where filler is placed is between the bone and the overlying muscle. Instead of using a silicone implant in the operating room, I place a thicker, longer-lasting hyaluronic acid filler without surgery in my exam room in a matter of minutes.
This placement between the bone and the muscle helps to keep the bone structure’s consistent shape, rather than the amorphous shape that can occur when filler moves around in the more superficial soft tissue space, so as a result, the face appears more youthful, and more natural. The procedure is carried out with blunt cannulas that minimize trauma in the injection, allowing patients to notice their improvement immediately.
Benefits
How Long Does Cheek Fillers Last?
Longer lasting fillers, such as Juvederm Ultra Plus or Juvederm Voluma, can produce results that last for more than a year and up to two years. It should be noted that the filler material used in this Structural Volumizing technique is more than that used in traditional superficial soft tissue placement.
Other Applications for Structural Volumizing
Structural Volumizing is not limited to the cheek fillers. I can use Structural Volumizing wherever I would have previously considered placing a surgical implant: the chin, jaw angle, jawline, and tear trough are all included. In fact, in some patients this global approach to facial volume correction has become an alternative to a surgical facelift, as well as a strategy to improve appearance after facelift
Recovery
Conclusion
Meeting the needs of busy patients who want safe, predictable procedures with minimal risk and downtime has been the driving force behind my innovations throughout my career. From performing cosmetic eyelid surgery, and facelift surgery under local anesthesia with LITE IV sedation, bringing into focus the needs of different ethnic groups which require specific approaches to cosmetic eyelid surgery, and the development of a system for non-surgical treatment for male and female pattern hair loss, I can state that the application of long lasting fillers using the principles of surgical implant placement is another significant step in meeting the needs of a wide range of people in the modern world.
Cheek Fillers Manhattan NYC and Long Island, New York
Dr Amiya Prasad is a Board-Certified Cosmetic Surgeon, and Fellowship-Trained Oculofacial Plastic and Reconstructive Surgeon. He’s been in practice in Manhattan and Long Island for over 25 years. To schedule a consultation, fill up the form below or contact any of our offices at (212) 265-8877 for Manhattan, New York City; (516) 742-4636 Garden City, Long Island; or (703) 356-1336 for Vienna, Virginia.