Even if you’ve never had dermal filler injections, you can imagine how they might make a big difference on someone’s lips or undereye area. But there’s another region of the face where the impact of fillers is under-appreciated: cheeks. A skilled aesthetic practitioner can use cheek fillers to remodel not just the cheeks, but also to improve the appearance of the whole face.
WHY SHOULD SOMEONE CONSIDER CHEEK FILLER INJECTIONS?
The midface is important in facial aesthetics because, according to a majority opinion, cheekbones and their structure constitute a significant percentage of what makes a person attractive. They’re central to the face’s structure, helping elevate and lift the middle part of the face. Cheek contours create shadows in that area that cause a look of pleasant slenderness. The aim when receiving cheek filler injections can be as simple as enhancing this very important facial feature. But there are other specific goals that someone might have, such as rejuvenating the face, creating cheek definition, or improving facial harmony.
We tend to feel that wrinkles and loose skin are the primary culprits that make us look older. Yet something else is just as guilty, and that’s loss of facial volume. Lack of volume in the cheeks can give you a tired appearance that makes you appear less youthful. Mother Nature causes us to lose facial volume as time goes by. It can also happen to individuals who suffer an illness or undergo dramatic weight loss. Genetics is sometimes to blame — some of us just have thin faces. Whatever the cause, having filler injected in the cheek area can add fullness and define the cheekbones. This restores volume and the natural contour of the face. It has a lifting effect on the cheeks, which in turn makes the whole face look younger.
CANDIDATES FOR TREATMENT WITH CHEEK FILLERS
It isn’t only those of a certain age who seek out this treatment. Getting filler in the cheeks is capable of producing such an effect that twentysomethings consider having the procedure. This isn’t all that surprising, since studies have shown that the faces considered most beautiful or interesting usually have high, defined cheekbones. Filler can make the cheekbones more prominent. It’s a way to mark this facial feature to enhance what’s already there. It can draw attention away from the roundness of a face. With a flat midface, filler can add fullness and shape so the face doesn’t appear as thin.
Filler in the cheeks is unlike filler in other places like the lips, where it will change the appearance of only that part of the face. Practitioners can use cheek fillers to create better overall facial symmetry. “Can you make my face look chiseled?” is a common request doctors receive from younger people. While it’s the cheeks that acquire a higher profile, the whole face benefits. The reason for this has to do with the way beauty is perceived.
Balance, proportion, and symmetry are characteristics that have been associated with beauty in general and with an attractive face in particular from Leonardo Da Vinci’s day to the present. One of the ways aestheticians help their patients achieve a harmonious facial appearance is by concentrating on the golden ratio. Da Vinci used this proportion in some of his famous works because it makes things pleasing to the eye. The face is divided into thirds from top to bottom. The closer those thirds are to being equal in size, the more attractive people think the face is. The cheeks define the line that separates the middle and upper third. Enhancing the contour of this line helps make the face look well proportioned, giving it a more harmonious, and by extension, beautiful appearance.
Restoring volume in this area of the face, so close to the upper third, makes it look more youthful, too. That’s due to something called the triangle of youth.
THE TRIANGLE OF YOUTH AND CHEEK FILLERS
Perceptions of facial attractiveness are largely founded on the synergy of the nose, lip, and cheekbone areas, what’s basically a central facial triangle. To see the triangle, imagine you are joining the highest point of each cheekbone with the center of the chin. In those with very symmetrical features, the triangle is equilateral. What’s more important is that for everyone who’s young the triangle points downward. The widest part is at the top of the face connecting the cheekbones and the tip is in the chin.
As the decades pass, the triangle ends up inverted. The base of the face widens, leaving the two lower vertices of the triangle on the chin and the upper one on the nose. This is mainly due to the loss of the collagen and fat found in the midface. If we look at an older face, we can see how the area of the temples and cheeks has sunk, and there is instead an excess of volume in the jawline and chin area. The visual effect of this change is that the face looks tired, with poorly defined contours.
The downward direction of the facial triangle is an indicator of age. Replacing the lost natural contours and volume of the cheek area fights this. It causes the tissues to rise and relocate, helping restore the triangle to its version from our younger days. Also, the folds on either side of our noses and mouths tend to become more noticeable when there’s less volume in the cheeks. So, the appearance of that area is indirectly improved when someone has cheek fillers.
Of course, when it comes to change, you don’t want to go overboard and end up with results that don’t look natural. Subtle effects are what everyone wants nowadays — much more Cate Blanchett and a lot less Angeline Jolie’s Maleficent character. Getting cheek implants, an invasive procedure, used to be the only real way to reshape this area of the face. Luckily, that’s no longer the case. Dermal filler injections are an outpatient procedure that takes less than an hour.
TYPES OF CHEEK FILLERS
There are different kinds of injectable cheek fillers, and each has its own advantages and drawbacks. Most aesthetic practitioners recommend one of three options.
As time passes, everyone’s skin has smaller quantities of the substances that give it elasticity and tone. These include collagen, elastin, and hyaluronic acid. The latter is a sugar molecule your body produces that attracts water. Because this acid’s main function is to hold on to moisture, it ends up playing a large part in keeping skin firm and plump. Dermal fillers derived from hyaluronic acid are the go-to product for many dermatologists. These are products that help skin recover firmness so that it can look more like it did before the aging process took its toll.
Hyaluronic fillers have several advantages. One is that repeated injections lead to a cumulative formation of elastin and collagen. The biggest advantage is that this filler’s results can be undone if you don’t like how you look. An enzyme called hyaluronidase is capable of dissolving hyaluronic acid. Knowing this can make patients, especially first-timers, feel more at ease.
Doctors often favor two FDA-approved fillers for use in the cheeks, Juvederm Voluma and Restylane Lyft. Both of these fillers are considered stiff. This means they’re thick and have a large particle size. That makes them excellent for lifting and sculpting areas that need structure like the cheekbones.
With hyaluronic acid fillers, you will notice some difference right away, but you might need to wait up to two weeks to see the complete outcome. Voluma and Lyft are some of the longest lasting cheek fillers, with results that remain visible a year and a half or two years after treatment. Of course, your mileage may vary, as they say. Your unique metabolism and how much movement there is in the cheekbone area will have a lot to do with the rate at which a filler’s effects disappear.
Sculptra consists primarily of poly-l-lactic acid, or PLLA, the material absorbable stitches are made from. It’s considered a biostimulatory filler because it’s designed to promote the gradual growth of your own collagen. For this reason, outcomes with Sculptra look very natural. The drawback is that collagen growth happens slowly, so those outcomes won’t be noticeable immediately. It may be a month or more before a patient sees the results. Patience can pay off, though, as the effects of Sculptra injections can last over two years. You do need to feel sure before getting Sculptra because there is no substance like hyaluronidase that can undo the results.
Another biostimulatory filler, Radiesse is a gel that contains calcium hydroxylapatite particles. Its effects in increasing volume are noticeable right away. It also stimulates natural collagen production, and the results last a long time compared with hyaluronic acid fillers. But like Sculptra, you can’t take back the outcome because there’s nothing that will dissolve Radiesse.
You should always entrust cheek enhancement with fillers to expert hands. A good aesthetician will offer a clean environment to his patients, make sterile conditions a priority, and never use leftover filler or needles from previous clients on new ones. Above all, they will listen to your goals for treatment and offer tailored advice. That way you’ll be sure to end up pleased with your new look.