The position and fullness of your cheeks can impact your facial symmetry and overall attractiveness. Droppy or sunken cheeks can make your face appear disproportionate, emphasize the appearance of fine lines and undereye wrinkles, and make you look older. This is because the cheeks are one of the three landmarks of the face (together with the nose and chin), and if any of these features is out of proportion, it can impact the overall symmetry of your face.
Unfortunately, not everyone is born with the right volume in their cheeks. People also tend to experience sagging and volume loss in their cheeks as they age. Thankfully, patients can turn to a number of cheek augmentation procedures to address these concerns.
What are the Different Cheek Enhancement Procedures?
Patients can undergo a number of procedures to add volume or lift to their cheeks. These include cheek lift surgery (also known as a mid-facelift). This minimally invasive procedure may involve a number of surgical techniques, including fat grafting and transfers, as well as the use of cheek implants. Non-surgical options include the injection of dermal fillers.
Let’s examine the various procedures in greater detail to help you decide which one is right for you.
Cheek Lift Surgery
Aside from lifting drooping cheeks and softening fine lines, cheek lift surgery aims to restore fullness to the mid-face area and reduce the prominence of sunken or puffy under eyes, dents on the upper cheek, and deep nasal folds.
Your facial plastic surgeon may employ a number of advanced cheekbone surgery techniques to lift your cheeks to their desired position and make them appear plumper, giving you a rejuvenated appearance.
In most cases, sutures or endotine fixation devices are used to keep the cheeks affixed to their newly lifted position. Cheek lift surgery also often involves the use of local or general anesthesia, or twilight anesthesia.
Once the patient has been sedated, your plastic surgeon will begin by creating minimal incisions, typically above each ear and behind the hairline. He may also decide to create incisions beneath the lower eyelashes and on the gum line inside the upper lip.
The surgeon will then carefully lift the skin, underlying fat, and muscle of the cheek area to resuspend them to a higher position. A meticulous surgeon with an artistic eye will make sure to avoid an overdone or overly pulled look. He will then secure the operated area using the aforementioned sutures or fixation devices.
No patient receives the exact same procedures and anesthetic options, as different patients have unique goals and needs, as well as facial anatomy. A brow lift is sometimes combined with cheek plastic surgery to rejuvenate a greater portion of the face.
Aside from being minimally invasive, cheek lift surgery is known to yield more natural results, making it the recommended rejuvenation option for patients with minimal to moderate signs of aging.
Following the procedure, patients can expect the following results:
- Smoother undereye area
- Improved cheek contours
- Less prominent fine lines and wrinkles
- Slimmer facial contour
Patients who’ve experienced considerable volume loss in the cheek area may benefit from cheek implants. These are biologically-compatible solid materials that can be installed in a targeted portion of the face to enhance its physical structure and improve overall facial proportions.
Cheek implants are made of several materials, with solid silicone being the most widely used. Silicone implants are advisable options for patients who want to add significant volume and fullness to create a lifting effect.
Other popular options include implants made from high-density porous polyethylene (Medpor) and ePTFE (expanded polytetrafluoroethylene), also known as Gore-Tex. Both Gore-Tex and Medpor are inert substances that provide better integration with the underlying tissue and bone than solid silicone implants.
Cheek augmentation with implants is usually an outpatient procedure, though this would depend on the complexity of the cheek surgery. One technique is to make small incisions inside the mouth near the top of the gum line and slide the implants into place. Another installation method is to make external incisions near the eyes to install the implants.
Both approaches have their pros and cons. While the intraoral (or inside the mouth approach) leads to zero scar visibility, there’s also a higher infection risk due to the mouth containing more bacteria. The external method, meanwhile, is less popular with patients as it leads to visible scarring.
Patients who undergo this procedure can expect the following benefits:
- Higher, fuller cheeks
- A more youthful and energized appearance
- More balanced facial proportions
Dermal fillers, sometimes referred to as injectable fillers, are less intrusive means of providing lift and volume to the cheeks. Dermal fillers temporarily replace the lost volume with biosynthetic materials, such as hyaluronic acid.
Aside from enhancing volume in the cheeks and lips, dermal fillers can also reduce the appearance of fine lines and wrinkles. Popular cheek fillers include Restylane Lyft, Radiesse, Juvederm Voluma, and Sculptra.
Radiesse is almost exclusively used for cheek enhancements and can last up to 18 months. However, this material is volume based and therefore should not be injected anywhere near the lower part of the eyes or the upper lip.
Restylane Lyft, on the other hand, can be used on other parts of the face but is also ideal for the cheeks and improves skin hydration. One of the first fillers made specifically for cheek enhancement, Juvederm Voluma can counteract aging by restoring lost volume and subtly lifting sagging skin. Finally, Sculptra is a filler that helps replace lost collagen stores in the cheeks and transforms it into plump and smooth skin.
To prepare for the treatment, ice packs and topical anesthetics may be used to numb the area and prepare it for the injectable filler. Depending on the patient’s tolerance for pain, local anesthesia may also be administered. Some fillers, such as Juvederm, contain a mild anesthetic called lidocaine, which should instantly numb the area to be injected.
Upon anesthetizing the cheek area, a controlled amount of filler will then be injected into the targeted area. Depending on the desired volume, more injections are performed to generate natural and equally distributed results. In between injections, the area may be repeatedly massaged to assess whether additional filler is required.
Patients who undergo this procedure can expect the following benefits:
- Smoother skin
- More sculpted facial contours
- Enhanced volume in the cheeks
Also known as fat grafting, a fat transfer is a minimally invasive procedure that uses the patient’s own fat cells harvested from donor sites on their bodies. The fat cells are taken from areas such as the stomach, thighs, love handles, and back of the arms. This will then be injected into facial areas that need added volume, including the cheeks.
The first step in this process is the collection of fat from certain areas through liposuction, either using a syringe system or a system that has a fat collection chamber. The fluid obtained during liposuction is then sterilized to get a concentrated amount of fat.
Fat grafting cannulas are then used to transfer fat into the cheeks. The surgeon may inject the fat into many tunnels and layers for the fat to be evenly dispersed.
Patients who undergo fat transfer procedures can expect the following benefits:
- Enhanced facial contours
- Lifted, voluminous cheeks
- A youthful, rejuvenated appearance
- Smoother skin texture