Everything You’ve Ever Wanted To Know About Cheek Fillers

Fillers are one of the most popular minimally invasive cosmetic procedures on the market, with approximately 2.6 million Americans getting fillers each year. And with results that include restored volume, contouring, and a more well-rested and glowing appearance, it’s not hard to see why. Among those opting for filler, one of the most popular locations to treat is around the cheekbones. (Other options include the lips or under the eyes.) Cheek filler is often used to create the appearance of high cheekbones, and can accomplish a whole host of other beauty goals as well. But cheek fillers can come with a host of potential side effects and complications that go beyond what is typical with injections like Botox, and in the hands of an inexperienced practitioner, can also lead to bruising, swelling, and puffiness. With all of these caveats in mind, it pays to do your research before investing in cheek filler.

So, being curious about what exactly cheek filler can accomplish, and what a person should know before considering getting cheek filler themselves, I sat down with three dermatologists to get the 411 on everything you need to know — from the different types of fillers available to post-appointment care to the risks that can accompany this wildly popular minimally invasive procedure. Here’s what the experts had to say about getting cheek filler in 2022.

What Are the Benefits of Cheek Filler?

The essential premise behind fillers — which are typically the texture of gel and injected under your skin — is that they help correct visible signs of aging, specifically as it relates to volume loss. As we age, we lose subcutaneous fat, which is what gives our face volume. This can lead to stretching and sagging — which isn’t ideal even on its own — and can also make wrinkles and lines more noticeable and pronounced. “Aging women lose volume, and look older,” says Nurse Tara Adashev, APRN at Neinstein Plastic Surgery. At its most basic level, what filler is doing is replacing volume in your superficial and deep fat pads, the most common locations to lose it.

As for the impact of restoring volume on the overall shape of your face, it can be dramatic. “When you're younger, the triangle of your face really has its base along your cheekbones, with the apex down at your chin,” explains Dr. Sarah Allen of The Skin Clique. “As you get older, everything starts to pull down and melt. And so your triangle changes and your apex is at the top of your nose and the base is down around your jaw.”

This is why, counterintuitive as it may seem, fillers can create a contoured look. “Cheek fillers can create fullness in the mid-face with full high cheekbones,” says Dr. Michele Koo, board-certified plastic surgeon and founder of Private Practice by Dr. Koo. In other words, your jawline can actually look more snatched simply because you’ve lifted and filled your upper face (which again tends to lose soft tissue as you age.

One of the more surprising benefits of getting cheek filler is that it can help with hollowness under the eyes. “There are two ways you can get filler,” Dr. Allen says. “One is on your zygomatic arch — your cheek bone. Or you can get it anteriorly with a cannula, that helps fill out under your eyes.” (A cannula is a thin tube that is inserted into a vein or body cavity to administer a fluid.) So those who find themselves told by the dermatologist that they aren’t a good candidate for undereye filler can often achieve a similar effect with cheek filler, provided they go to the anterior route.

What Are The Different Types Of Cheek Filler?

There are multiple types of fillers to choose from, and what effect you’re looking to achieve will determine which your practitioner selects.

Hyaluronic Acid Filler

One of the most common is hyaluronic acid filler, which includes brands like Juvéderm and Restylane. Hyaluronic acid can be a particularly good choice for people looking to work on skin texture issues as well, such as acne scars and marionette lines. The results are not permanent, and typically last between six and 18 months.

Permanent Filler

Polyalkylimide filler (known as Aquamid) is meant to be permanent, although typically reversible, and can be used for all the same purposes as hyaluronic acid filler: the difference is its longevity, although complications have been reported over time with polyalkylimide fillers.

Collegen Stimulating Filler

Finally, polylactic acid filler — aka Sculptra — is a synthetic filler that stimulates your body’s own production of collagen. Unlike hyaluronic acid fillers, which are immediate, you’ll have to wait a few months for results, which are dependent on that collagen generation. Patients need an average of three monthly sessions to see results, which are semi-permanent.

What Cheek Filler Should You Choose?

So how do dermatologists decide which type to use? That depends on a patient’s goals and budget, along with the effect they are looking to achieve. “The exact location of the desired fullness often dictates which filler I choose,” Dr. Koo says. “I like to start with Juvéderm XC in the cheek area and layer more as my client becomes comfortable with a fuller cheek appearance. If they go on to love the new look and the exact shape and position of the full high cheekbones established, I will transition to Sculptra.” (If you’re looking for longer-lasting results, this can be a good option).

In Nurse Tara’s office, Voluma, Restylane Lyft, and Radiesse (all brand names of filler) are the most popular options, and all provide a different look. “Radiesse is great for emulating bone and lasts the longest, while also stimulating your own collagen. Restylane Lyft is great for giving a cheekbone [support underneath the skin] and Voluma gives a chiseled look.”

In order to choose the best filler for you aesthetic goals, prepare for a thorough consultation with your dermatologist, outlining your budget and how long you’d like the results to last.

How Much Does Filler Cost?

The cost of filler will be determined by the type of filler used, along with how many syringes are necessary to achieve the desired result. According to the American Society of Plastic Surgeons, a syringe of hyaluronic acid filler typically runs about $684, while polylactic acid is $853 per vial. The average number of vials for cheek filler ranges between two and six vials total.

How Do You Prepare For Cheek Filler?

Before your appointment, you’ll want to think long and hard about the answers to those questions: your vision for the results, how long you want them to last, and how much you can spend. Visual aids can be helpful in ensuring that you and your practitioner are on the same page in terms of aesthetics. Nurse Tara asks patients to think in terms of photographs. “If you zoomed in your own face,” she likes to ask patients, “what would you enhance?” Come prepared with answers to these questions, so you can make the most out of your appointment.

It’s also best to avoid alcohol in the 48 hours before an appointment as alcohol can lead to a higher likelihood of bruising. Same goes for Aspirin — consult your provider for what OTC pain killers can help prior to your appointment.

What Happens At A Cheek Filler Appointment?

Once you have decided on a course of action, your provider will clean your skin and numb the injection site with topical anesthetic. Then they will inject filler just beneath the surface of your skin. “The filler is laid either in the deep plane just superficial to the zygomatic arch or infra zygomatic bone area,” Dr. Koo says. “It can also be injected in the deep dermis through the inside of the mouth or directly through the skin. I do a combination of both and from multiple entry points to allow for round 3D sculpting.” In other words, your derm might come at you from a few angles to get the best results, but you won’t be under any anesthesia, nor will you need any. Filler is non-invasive, and typically a quick procedure. In terms of pain, the topical numbing cream should take care of any and all sensation, but you still might feel a sharp pinch.

What Filler Aftercare Should You Practice?

After your appointment, you may be advised to go easy on strenuous activity such as intensive exercise for up to 48 hours. Dr. Koo advises her patients to ice, along with avoiding strenuous activity for two to seven days in order to minimize the risks of bruising and swelling. Nurse Tara tells patients to avoid massaging the area, along with avoiding alcohol and Advil.

How Long Do Cheek Fillers Last?

Depending on the type of filler used, results can be immediate. And fillers typically last longer than Botox: for example, results from hyaluronic acid fillers typically last between 6-12 months - although Juvederm may not last that long depending on your metabolism. Those with higher metabolisms will often break down filler faster in the body. Over time, all but permanent fillers will dissolve on their own in your body, thanks to a naturally-occuring enzyme called hyaluronidase.

Are Cheek Fillers Reversible?

One of the perks of filler is that if you’re not happy with the result for whatever reason, your practitioner can inject an enzyme that will dissolve filler within one day. The cost for reversing cheek filler is typically $100-200.

What Are Potential Side Effects?

Fillers are considered to be a safe cosmetic treatment, but as with most procedures, there are some potential side effects and risks. Among the most common are redness, bruising, and swelling in the injection site. This should go away within a week or so. Some patients also develop biofilms, which are nodules encapsulated by bacteria, which often need to be treated with antibiotics and steroids. The most important factor in preventing biofilms are sanitary procedures practiced by your derm, so make sure that your practitioner errs on the side of extremely clean rather than casual as they perform the procedure and all steps around it.

Less frequently, side effects of filler may include bleeding at the injection site, skin reactions, and rashes, along with flu-like symptoms including headaches and nausea. “Don’t ever go into an injection procedure thinking there are no risks,” Dr. Koo says. “You can be extremely unhappy with the aesthetic results, have significant bruising and swelling, and lumps and bumps and distortions around the cheeks.”

Technique matters, so make sure that you are seeking out a board-certified dermatologist — filler is not a case where shopping around for a Groupon deal is going to be your best course of action. “If the placement of filler is too superficial, it could result in unnatural skin bumps and whiteness,” Dr. Koo says of potential filler migration. “And fillers also don’t last as long if they aren’t placed in the right skin plane.”

In all, cheek filler is fairly low risk way to reverse signs of aging, give you cheekbones you may have never had, and make your undereye area look fresh and rested. And who wouldn’t want that?