Getting facial injections and dermal fillers used to be totally taboo. If you got them, you probably didn’t talk about it. However, over the past decade, the stigma attached to these types of cosmetic dermatology procedures has relaxed. According to the American Society of Plastic Surgeons, in 2020, in the midst of the pandemic, over 4.4 million people were injected with Botulinum (aka Botox, Dysport, etc.) while 3.4 million opted for soft tissue fillers. So, if you’re interested in temporarily erasing wrinkles or plumping up your face, you are in good company. Cheek fillers are an easy way to add some dimension to your face without going under the knife or making a long-term commitment. And, while some people gravitate toward overfilling, adding some volume and definition to the cheekbones can be so subtle that even your closest friends and family won’t be able to notice—including your significant other. But what are cheek fillers, exactly, and how long do they last? Do they hurt? Because I am a true guinea pig when it comes to non-invasive procedures, when Allergan invited me to the newly opened Skin Spirit, Upper East Side in New York City to plump up my cheeks, how could I refuse? However, before sitting down in the practitioner’s chair, there are a few things I wanted to know about the popular treatment. Here’s everything you need to know about cheek fillers, along with my personal experience in getting them.
What are cheek fillers?
Jason D. Bloom, MD, FACS, Facial Plastic & Reconstructive Surgery, Bloom Facial Plastic Surgery, Bryn Mawr, PA, explains that cheek fillers are FDA-approved dermal fillers for use in the mid-face and cheeks. There are two main types of cheek fillers, hyaluronic acid (HA) and calcium hydroxylapatite (CaHa), he explains. HA fillers, which include Juvéderm, Restylane, Belotero Balance, and Revanesse Versa, are made of hyaluronic acid, the same naturally occurring substance found in your skin. These fillers are soft and gel-like. CaHa is also a naturally occurring substance, but found mostly in the bones. Particles in these types of fillers, most commonly Radiesse, are nearly microscopic and suspended in gel. The result? A slightly thicker substance compared to HA fillers. The purpose of both types is the same: To add volume to the cheek and mid-face region where it might need a boost. Kathleen Suozzi, MD, director of aesthetic dermatology at Yale Medicine and assistant professor at Yale School of Medicine, explains that within each family of fillers, there are different products catering to specific needs. “For example, Voluma is a cheek filler in the Juvéderm family that I would use for the most lifting,” she says, explaining that it offers the most structural support in the midface, often lost from aging or simply due to normal anatomy. Structural fillers help you “lift and tack back skin even in the lower face and give the skin a more give the face a more balanced appearance,” she says. “In contrast, sometimes I’m using cheek fillers not so much for lifting, but to give the cheeks a soft supple appearance,” she continues. “For this, I might use a product like Juvéderm Ultra Plus, which is softer, not as structural, and it’s just going to give a pretty fullness to the cheek.” This type of product is often requested by younger patients, looking to add more suppleness in the mid face. I opted for Juvéderm Voluma, which is Allergan’s most popular cheek filler. Cheek Filler before and after photos provided by Skin Spirit
The consult
Prior to getting any type of invasive or non-invasive procedure done, the initial consultation with your practitioner is one of the most crucial aspects. It is extremely important to be clear about the results you are seeking and to ask any questions you might have. “Whether or not you should get cheek filler, that should be a discussion you have with your dermatologist,” Dr. Suozzi maintains. “Your dermatologist will do a consultation where they will assess your face and determine what type of soft tissue augmentation you might need.” The first thing I usually ask the practitioner is what they think I need. Despite what you might think, most esteemed derms and PAs, NPs or nurses won’t try and oversell you and/or over-inject you. They want you to look good, because then you’ll come back and bring your friends. In fact, most of them tend to make recommendations on the conservative side and many will even refuse to over-plump patients up. “Sometimes patients come into my office and say they want to address the lines around their mouth or their lower face. But really when I do the assessment, I see that they need balance in their mid-face and their upper face and will talk to them about cheek fillers or mid-face fillers,” adds Dr. Suozzi. During my consultation with Shawna Jones, an aesthetic physician assistant and Allergan Medical Institute Trainer, she explained everything to me in great detail and even walked me through the entire procedure, step-by-step.
How much filler will you need and how much does it cost?
The amount of filler needed varies by case. Unlike Botox, which is priced per unit, filler is sold by syringe. Costs vary by brand, practitioner, and where you are in the country. “In general, the fillers range between $600-$1,500 per syringe and most patients do on average two to three syringes to treat the cheek and mid-face areas,” says Dr. Bloom.
How are cheek fillers administered?
The process of administering cheek fillers is quite simple. Dr. Bloom explains that most people opt for topical numbing prior to getting the infections, which can reduce any discomfort. I suggest you make time to do this. While I have never gotten cheek fillers without numbing cream, I can attest to the fact that it works pretty well in terms of alleviating pain. After the area is numb, which generally takes around 20 minutes, you are ready for the filler. Both types of cheek fillers come in a syringe and are administered by a doctor, PAs, NP, or nurses with a combination of a needle and/or cannula. The practitioner strategically infuses the filler into the cheek area, shifting it around to inject the gel into the desired area.While the filler is going on, there is often a loud crackling sound. It sounds worse than it feels. They may inject into different areas. They will also check their work to make sure it is symmetrical and even. It usually takes less than 20 minutes for the injector to work their magic.
What do cheek fillers feel like and do they hurt?
Fillers look like they hurt. A lot. This isn’t always the case. Obviously, pain is relative and is majorly dependent on whether or not you opt for numbing cream, which can reduce any discomfort. Most people describe the sensation of filler being administered as “pressure” versus “pain,” which I can attest to as being accurate. I would add that it also feels a bit awkward, especially if you are a virgin to fillers. But honestly, the pain was probably a one out of ten.
What should you expect after treatment?
Dr. Bloom suggests icing the area for a bit post-treatment and even gently massaging it. I was given an ice pack and used it for about 30 minutes to discourage any swelling. However, post-treatment slight bruising or swelling is to be expected. In fact, you might be overwhelmed (or overjoyed) with how your cheeks look. For better or worse, keep in mind that the volume will likely decrease in the days or weeks following. You might also notice that one cheek is slightly bigger or shaped differently than the other. This too can be totally normal and a result of swelling. I can attest to the fact that my cheeks majorly settled down in a few weeks. Most practitioners will tell you to come back after a few weeks to a month if you are left wanting more volume. They would much rather add more filler for you than have to dissolve any excess.
How long do cheek fillers last?
Dr. Bloom explains that while many of the cheek fillers on the market have an FDA approval for one to two years, they tend to dissolve sooner. “I like to explain to patients that when they are done conservatively, most patients will want to get touched up for some more improvement in about nine to 12 months,” he states.
What if you don’t like them?
The good news about getting hyaluronic acid fillers is that they are temporary and will gradually dissolve within a year or so. However, if you want to dissolve them immediately, the process is quite simple. Just return to your practitioner and they can inject an enzyme called hyaluronidase, which dissolves the hyaluronic acid particles.
Should you get cheek fillers?
As with any aesthetic cosmetic procedure, only you can decide if cheek fillers are right for you. However, most top dermatologists in the country—Bloom and Suozzi included—maintain they are a safe and effective procedure that can boost your self-confidence. “I am a big fan of mid-face/cheek fillers when done by a professional who understands the technology and conservatively uses the products,” says Bloom. One important thing to note is that you should choose your practitioner wisely. The American Academy of Dermatology Association recommends that you see a doctor who has expertise injecting fillers and many satisfied patients. “The results you see depend largely on the experience of the person performing this procedure. A dermatologist has the knowledge and experience required to inject fillers safely and effectively,” they explain. While it might be tempting to try to save money by purchasing a Groupon or finding someone who advertises a deal in your local paper, those people generally don’t have the training, experience, or reputation of other more esteemed experts. Personally, I’m a fan. My end result was extremely subtle and extremely natural-looking, to the point that my husband didn’t even notice the difference. I wasn’t left with huge chipmunk cheeks, but instead, a little added definition where I needed it the most. I ended up looking like a younger version of myself, not somebody else. Next up: How Young Is Too Young for Botox?
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