23 July 2020
Cheek fillers– If you feel that your cheeks are sunken, laugh lines (nasolabial folds) and dark eye circles are getting more obvious; there’s one area of your face that is causing these features to worsen. The midface is one of the most prominent parts of the face and the middle of the face is also where early signs of aging show.
The midface is made up mostly of our cheeks. As we age, bone; skin and soft tissue changes occur. This leads to deflation of our cheeks (i.e. flatter cheeks) and sagging in the midface. These changes lead to the transition from the lower eyelid to the cheeks to become more abrupt, leading to dark eye circles and eye bags worsening. The descent of the cheeks also causes the nasolabial folds too look thicker. These impact of the cheek on the lower eyelids and laugh lines is a reason why the cheek is also addressed when eyebags, dark eye circle and nasolabial folds are corrected. You can also see how I correct eye bags in this blogpost How to Get Rid of Eye Bags without Surgery: Under Eye/ Tear Trough Fillers.
Besides making us look younger and more refreshed, cheek fillers can be used to sculpt the face. This review will look at what cheek fillers do, the types of cheek fillers available and what cheek filler injections in Singapore are like.
Our cheeks are the most prominent part of the midface. The natural cheek volume and projection of our faces affect the 3D profile of our faces.
Cheek fillers can be used to sculpt the face to enhance facial proportions. A common reason for my patients in Singapore seeking non-surgical cheek augmentation is the correction of their ‘flat cheeks’ as flatter and wider faces are more common in East Asians. The 3D shape of our faces is determined by the shape of our bones (i.e maxillary and mandibular bones) and thickness of the overlying soft tissues (i.e. skin, muscles and fat). How flat (or full) our cheeks look is determined by the bone and soft tissue structures in our faces.
One way of describing ideal cheek proportions is to assess the Ogee curve of the face. The ogee curve is used to the gentle S shaped curves seen on youthful faces from an oblique angle. In facelift surgery and liquid facelift with cheek fillers, one of the aims is to restore the Ogee curve for a youthful appearance.
The trend of apple cheeks or a heart shaped face is another popular reason for patients seeking cheek filler injections in Singapore. Apple cheeks refer to plump looking cheeks, which is a sign of youth in some Asian cultures. A number of Asian celebrities such as Angelababy and Korean superstar Song Hye Kyo have this coveted silhouette on their faces. Apple cheeks and heart shape faces can also be seen in Hollywood celebrities like Cameron Diaz and Scarlett Johansson.
Did you also know that cheek filler injections form the basis of rejuvenation of the whole face? Cheek fillers can lift the face to correct sagging? Cheek filler injections are part of the Liquid Facelift, a minimally invasive and non-surgical facelift using a combination of dermal fillers and Botox (botulinum toxin).
Besides lifting the cheeks and restoring volume loss in the cheeks due to aging, cheek fillers can lift other parts of the face too. Small amounts of filler are placed strategically in the cheeks to gently lift the laugh lines and reduce dark eye circles and eyebags. In the Liquid Facelift, the aim to restore youthful facial proportions, so that the overall result is a younger and more refreshed looking appearance. The most common complement that my patients receive from their friends and colleagues is that they look more refreshed without anyone guessing that they had a little help from cheek fillers.
Who says that the men don’t get it? Men form a significant proportion of patients in my clinic getting aesthetic treatments too.
In males, the facial structure and ideal facial proportions are very different from females. Cheek filler injections can be performed in males as part of the Liquid Facelift and improve their facial proportions without making them look feminine. Stronger cheekbones are a sign of masculinity, so recreating cheekbones (as opposed to fuller cheeks in females) is a popular request I get from my male patients in Singapore.
I shared about aesthetic treatments for males in Buro Singapore, including cheek filler injections in this article These are the Treatments Singapore Men are Getting According to An Aesthetic Doctor.
What are the types of cheek fillers available in Singapore? Cheek fillers or dermal fillers are soft gels that are injected into the cheek to replace volume and lift the face. There are different types of fillers used in Singapore. The most commonly used dermal fillers in Singapore are hyaluronic acid fillers. You may have heard of brands of dermal fillers like Juvederm, Restylane and Boletero which contain hyaluronic acid. There are other types of dermal fillers that are less commonly used such as Polycaprolactone (Ellanse), Poly-L-Lactic Acid (aka Sculptra) and Calcium hydroxylapatite (Radiesse). These non-hyaluronic acid fillers are also called collagen biostimulators.
How do dermal fillers work?
When injected under the skin, hyaluronic acid dermal fillers plump up the face. Hyaluronic acid a water loving molecule, so it also attracts water molecules to hydrate the skin. Hyaluronic acid dermal fillers last approximately for one year.
Before dermal fillers are injected into the cheek, the face is numbed with numbing cream for 20 minutes in my clinic in Singapore. When the face is numbed, it’s time to begin.
Fillers can be injected into the cheek using a needle or cannula. Your doctor’s choice of technique will depend on the precise subparts of the cheeks that is injected. Some brands of dermal fillers like Restylane and Juvederm contain lidocaine, a numbing medication premixed in the filler. The addition of such numbing agents reduces the discomfort experienced with injections.
The results of cheek filler injections are instant. The results of volumisation and lift from cheek fillers can be seen immediately, as compared to Botox, which takes approximately 1 week to be seen. To learn more about the differences between fillers vs Botulinum toxin, please read this blogpost Botox vs Fillers: Differences, Uses, Effects and Myomodulation.
The results of cheek filler injections can be seen immediately, so hello to a younger and less tired looking you! You might experience temporary soreness and swelling in your cheeks afterwards, so please be gentle with your cheeks. Remember, dermal fillers are soft gels that may get displaced in the first week if you are not careful. It can take 1-2 weeks for the position of your cheek fillers to be stabilised; so avoid activities where your cheeks may get hit (e.g. kickboxing).
The aftercare for cheek filler injections is also pretty easy; you do not need special skincare. Just be gentle with your face, especially when you cleanse your face. Avoid drinking alcohol and supplements like ginkgo as they may worsen bruising.
It goes without saying that you should do a little homework before getting cheek filler injections! Have a thought about what you would like enhanced in your face and have a honest discuss about this with your doctor. Ultimately, your satisfaction with your cheek filler results will hinge on your goals and whether the ‘look’ harmonises with the rest of your features. It also helps to do some research on your doctor before visiting the clinic. For best outcomes, choose an experienced doctor for best outcomes.
The alternatives for non-surgical cheek augmentation include Profhilo and face threadlifts.
Profhilo is an anti-aging injectable treatment that contains hyaluronic acid, similar to dermal fillers. What is interesting about Profhilo is that it contains a combination of high and low molecular weight hyaluronic acid molecules that enhances collagen and elastin formation in the skin and adipocyte stem cell viability. With Profhilo injections, the skin is gently lifted, hydrated and firmer. However, Profhilo does not add volume to the cheeks so if you are looking replenishing flat cheeks, cheek fillers are preferred. If you are looking for a lift of your laugh lines, Profhilo is an alternative to cheek filler injections.
Face threadlifts involve lifting the sagging parts of the face using dissolvable threads. There is no volume replacement or ability to sculpt the cheekbones in a face threadlift, unlike cheek fillers. However, the lifting effect of face threadlifts is greater than cheek fillers.
The surgical options for cheek augmentation are: fat grafts and cheek implants. These surgeries are performed by plastic surgeons in Singapore.
Yes, cheek fillers can be combined with other non-surgical aesthetic treatments in the same setting.
Cheek fillers are commonly combined with dermal filler injections in other parts of the faces e.g. the nasolabial folds (laugh lines) and tear trough (under eyes). Botox (botulinum toxin injections) can also be done together to remove wrinkles for a more holistic anti-aging effect. You can read about the safety issues and side effects of Botulinum toxin in Is Botox Deadly? You can also learn about how wrinkles are formed and how they can be removed without getting a frozen face or overdone look in this blogpost Baby Botox and Preventative Botox.
Face threadlifts and cheek fillers are commonly performed together as the anti-aging outcomes are synergistic. Face threadlifts are first done to lift the face and cheek fillers are then injected to restore lost volume from aging. The advantage of this combination is that less cheek fillers are utilised and results are more natural.
The volume of cheek fillers that each patient requires depends on the pre-existing cheek volume and bone structure; severity of sagging; and the desired look. If you have flat cheeks due to hypoplastic maxillary bone structure, small cheek volume and prominent laugh lines (i.e. sagging), you will need more cheek fillers than someone with chubbier cheeks and less sagging.
On average, cheek fillers require 2-4 mls of dermal fillers. Excessive cheek fillers are not necessary. An overfilled cheek can cause the appearance of a Pillow Face and Sunset Eyes. You can read all about them in this review Fillers Gone Wrong: Telltale Signs of Too Much Filler Injections.
Cheek fillers are a non-surgical treatment to augment your cheeks and cheekbones. Besides plumping up the cheeks, cheek fillers can also lift the face to reduce the appearance of the laugh lines and dark eye circles. If you would like to restore volume in your midface and lift your face to look younger and more refreshed, cheek filler injections are a good consideration. You can also consider combining cheek filler injections with other anti-aging and skin enhancing treatments like Botox (botulinum toxin) or lasers in Singapore.
Lastly, your results and safety are dependent on the type of dermal fillers used and your choice of doctor; so choose wisely!