Full, round cheeks are a universal sign of youth for both men and women, across nations and cultures. Unfortunately, the aging process and sun damage create flatter and sunken cheeks due to natural facial fat and bone loss, in addition to sagging of tissue.
Facial fillers have grown in popularity over the years, as it’s a non-surgical option with minimal downtime performed by many cosmetic specialists. Some patients have avoided surgery due to factors such as lengthier recovery periods and fear of anesthesia. We spoke with a prominent facial cosmetic surgeon who used to perform many cheek implants (many years ago), but now performs them much less commonly due to the demand for fillers. While the total number of cheek implant surgeries worldwide has decreased due to the immense popularity of fillers, plastic surgery still remains a good option to enhance the cheeks for appropriate patients.
What are the options to enhance the cheeks?
We previously discussed the various plastic surgery options to create fuller, youthful cheeks in a previous blog post. Briefly, these include:
- Non-surgical – facial fillers, such as Voluma®, Perlane®, Juvederm®, Restylane®, Sculptra®, Radiesse®, or fat transfer
- Surgical – silicone implant, cheek lift, mid face lift
Results with non-surgical fillers last approximately 6 months to 2 years, depending on factors such as the specific filler itself and the patient’s tissue. Fat transfer results could be potentially permanent. Plastic surgery can provide permanent results.
Why consider cheek surgery with an implant?
Cheek augmentation with an implant may be desired by patients for several reasons. First, many cheek implant patients have tried fillers over the years and are looking for a more permanent solution. Second, some patients don’t like the idea of periodically coming to the plastic surgeon’s office to be “filled up” and would rather have just one procedure.
While facial fillers have revolutionized the field of plastic surgery, surgically inserted silicone cheek implants can still provide better 3D structure to the mid facial area than can soft tissue fillers. All soft tissue fillers are gels that are injected into the face, and therefore cannot provide the same cheek support as compared to a solid implant.
Some patients may have a congenital or acquired bone deficiency of the facial skeleton, so a solid implant can provide a more appealing aesthetic result. These patients often require many syringes of filler to potentially achieve their desired aesthetic results. As a result, they are likely to be overfilled with facial fillers and at a higher risk of developing an ill-defined, doughy appearance which is unnatural.
The before and after cheek augmentation photographs above show a patient with significant congenital bone and fat volume deficiency, which only worsens with age. He was seeking a long-term solution to improve his appearance and didn’t like the idea of facial fillers for the cheeks. After consultation with Dr. Chaboki, he underwent silicone cheek and chin augmentation. The entire surgery only took a couple of hours. His recovery was relatively quick and uneventful, allowing him to return to work quickly.
Lastly, while the initial cost of surgery is more expensive than fillers (surgeon fee, facility fee, implant fee, etc), the long-term cost is usually less expensive than using fillers over an extended period of time. In terms of price, the approximate break-even point between cheek implants and fillers is estimated to be approximately 2 years.
What about injections of permanent fillers into the cheeks?
The only permanent solutions for cheek enhancement are fat transfer and plastic surgery with a cheek lift or cheek implant. Other than fat transfer (which can potentially be permanent), permanent fillers should not be injected into the cheeks. Synthetic fillers can be long-lasting (ex. Voluma, Radiesse, Sculptra), but inherently should not be permanent. The primary reason for avoiding permanent fillers is the need to remove them in the rare case of complications, such as infection, irregularity, nodules, etc. Permanent fillers cannot be removed easily or completely, without causing additional tissue damage. Dr. Chaboki has treated patients who have had complications from permanent filler injections performed by other providers.
Have you consider cheek augmentation or facial fillers for cheek enhancement? Share your questions below.