Sunken cheeks - Are there any long-lasting dermal fillers available?
Having used both restylane and perlane, with passable results, I am now searching for something longer lasting. A filler that lasts longer than 6 months ?
I lack ''fullness'' in the face, especially around the nasal folds, I would describe it as ''sunken'. Should I consider a sculptured effect and have the Dr. '' fill out'' the sunken look, by filling out the cheek area to ''lift'' the folds ? Sadly, fat implants are not an option here.
It's so confusing, and even though you do the research, you are still left wondering which product ! I have also had 2 sessions with fraxel laser, which, truthfully did not do what I expected. I am slim petite frame and face, and coming up to the big 50 I just feel I look gaunt. Hope this gives you clear picture. Its not easy to describe oneself, and of course I have to temper my expectations ! Miracle cure, I live in hope. Thank you for your time.
Answers (3)
Fat Grafting Can be Ideal for Sunken Cheeks
my Raleigh, North Carolina Plastic Surgery Practice I use Fat Grafting to treat sunken cheeks. There are a number of 'soft tissue fillers' are available for temporarily improving facial areas that have lost volume or have developed deep lines and creases. Probably the most popular fillers currently are hyaluronic acid products like Restylane, Perlane or Juvederm which can be used to plump up thin lips and to fill out nasolabial folds (lines that run from beside the nostrils to the area beside the corners of the mouth) and marionette lines (lines that run from the corners of the mouth towards the jawline). The improvement generally lasts about 6 months and can last up to a year. I regularly use Juvederm, Restylane and Perlane in my Raleigh, North Carolina plastic surgery practice to fill lines and plump lips
For patients seeking permanent enhancement of soft tissue volume, the ideal material to use would obviously be something that is naturally-occurring and not rejected by the body or treated by the immune system as a foreign material. Whether the goal is to restore volume to an area such as the lips or the cheeks, or to fill in a crease or depression such as the nasolabial folds or marionette lines, the ideal material is quite clearly the material that one wishes was there in greater abundance in the first place: YOUR OWN FAT.
A relatively new technique has been developed called structural fat grafting, in which small amounts (less than 0.1 cc at a time) of fat are carefully microinjected in a series of discrete layers to gradually 'build' new soft tissue structure. As there is space between each microinjection, new blood vessels are able to grow into the grafted fat, allowing it to persist. If this process of blood vessel ingrowth (neovascularization) does not occur, then the injected tissue cannot truly be considered a 'graft' and is instead just another 'soft tissue filler' of limited duration.
This is a procedure that requires specialized training and specialized surgical instruments, as well as patience and attention to detail on the part of the surgeon. When performed properly, permanent improvements in facial plastic surgery are possible.
Alternate Options - Cheek Implant ot Fat Injections
Hello in Hong Kong,
Execellent answers to your questions from Dr. Lupo.
As a Surgeon I did want discuss two other options that you may find helpful.
You mentioned that fat implants are "not an option here". Is that for medical reasons or lack of experienced provider? For discussions sake, fat injections are a safe and effective way to restore volume to the face. Like some of the fillers multiple injections may be required to get the desired effect but the end results are worth it. This is becoming an increasingly performed procedure so maybe with time an expert will be available in your area.
I would also recommend cheek implants based on the description of your face. If your face is "sunken" and you look "gaunt" then a cheek implant is a very effective way to restore structural volume to the areas that look sunken. The procedure is simple and can be done with local anesthesia. The implants provide an effective and permanent way to "lift up" and support the sunken tissues. The nasolabial folds are also softened and the midface has a more youthful, rounded appearance.
Best of luck to you!
There are filler options that last longer
Mid-cheek atrophy can make you look gaunt and tired. Patients often feel that their face looks sunken and that the cheeks appears to sag.
I have found very good longevity with Juvederm Ultra Plus to correct this problem. It must be injected under the muscle and angled so the cheek is raised immediately upon injection. Patients typically have results that last 9-12 months.
I also have used Radiesse and found similar longevity and, in fact, it can last more than a year in some patients.
Sculptra is fabulous for some patients, lasting 2 years or more, but it requires more injection sessions and often takes 3-6 months for the full effect to be achieved.
Artefill is a permanent implant for the nasolabial fold, but has not been used much for mid-cheek atrophy. It might, however, be useful for severe cases.
Finally, I've had success with some tightening and lifting of this area with Titan in younger patients (under 50). Fraxel is very good for texture, lines, discoloration, and scars, but does not lift very well.
It is always best to discuss options with an experienced and reputable board certified dermatologist or plastic surgeon who will lead you to your best choice and explain all the risks and benefits.
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