Something that makeup artists understand exceptionally well and that we as cosmetic physicians can learn from is how light reflects on the face and the subsequent shadows that are created. This is done with highlighter and bronzer. However the same outcome can be achieved by creating an aesthetically pleasing shape to the cheek with dermal fillers.
Cheek fillers are a very common procedure aimed at restoring lost volume in the mid-face as a result of bone loss, atrophy of fat compartments and sagging of the tissues as a result of ageing.
What we can improve
- Size & symmetry
Some patients will have flat or underdeveloped cheek bones. This can be corrected to give a more balanced proportion to the upper, middle and lower thirds of the face. There may be also asymmetry between sides of the face due to sun damage on the drivers side or from sleeping predominantly on one side.
- Cheek ageing
As we age we loose volume in both the deep and superficial fat compartments in the face. This results in a sunken and tired appearance. One of the first places this occurs are in the cheek and mid-face. Restoring this lost volume in the cheek gives a more youthful and refreshed look.
Shape of the cheek is very important to create a natural and beautiful outcome in patients of all ages. It frames the face and gives structural support structures of the lower face. To aim is to create a soft curve from the side of the cheek with good forward projection and a smooth transition to the area around the mouth. There are very important gender differences that must be taken into consideration when injecting this areas so as to create a masculine cheek in men and a feminine cheek in women.
FREQUENTLY ASKED QUESTIONS
The general principles in choosing the specific dermal filler of replacing like with like also apply in the cheek. In older patients who have lost volume in the bone and deep fat compartments we will use a more structural filler that can give some lift and projection. However this is often combined with a softer filler that will be placed higher in the skin that will move naturally with facial expression. In a younger patient it is usual to use a softer filler.
Pain relief is generally not required in cheek filler as there is local anaesthetic in the filler and it is a very comfortable procedure.
The skin is cleaned with an antiseptic to remove any makeup or bacteria. The area to be injected is then marked up. Depending on the specific patient filler may be injected with a sharp needle or a blunt cannula.
As with any medical procedure there are some risks to consider. Most patients will have some degree of swelling associated with this treatment, but this will settle over the following few days. There may be some discomfort, bleeding or bruising. There have been cases in Australia of vascular injury whereby filler is inadvertently injected into a blood vessel. It is very rare but if it occurred could lead to necrosis of the skin or visual loss. A thorough knowledge of facial anatomy and safe injecting techniques can greatly minimise this risk, however if any signs were to occur the filler would need to be dissolved immediately.
Most patients can go back to work immediately, however as mentioned there may be some degree of bruising or swelling present. Pain is minimal with Panadol adequate if required.
No makeup or lipstick for 4 hours. No exercise for the next 24 hours. Avoiding alcohol that evening will minimise any bruising. Applying ice will also help with swelling and bruising. No swimming for one week.