Aesthetic Treatments

You Can Hear the Injection, and More Unexpected Facts You Might Not Know About Cheek Filler

cheek fillers
Lyuba Burakova

Does not imply person featured in the photograph had cheek filler.

In retrospect, there are a few things that probably would have been nice to know ahead of my very first appointment for cheek filler. It would have been helpful to anticipate, for example, how different the sensation would be compared to that of getting filler in my lips. Or, that this particular area of the face requires a bit more product — something that my needle-phobic self wasn’t necessarily prepared for. 

But above all else, I couldn’t have anticipated just how much I’d like the result — to the point that getting filler around my cheekbones has become just as important to me as getting treated with injectable wrinkle reducers. The fact that I can slip into my go-to medical aesthetics destination, Le Jolie® , and be out before the end of my lunch hour makes it convenient, too.

Editor's Note

Injectable wrinkle reducers temporarily smooth the look of moderate to severe wrinkles in certain areas of the face, including the forehead, frown lines, and crow’s feet; they should not be used more frequently than every three months. Injectable filler is a temporary treatment that adds volume to areas of the face such as the lips, cheeks, and laugh lines. Like any medical treatment, both injectable wrinkle reducers and injectable fillers have potential risks and side effects. Talk to a licensed provider to see if they’re right for you. 

The funny thing is that while my cheek filler results are wonderful, until recently, I didn’t even think to dig into why they have such a nice impact on the look of my face. This requires a bit of an anatomy lesson — and, for that, I turned to Kimberly Jerdan, MD, an LA-based board-certified dermatologist and cosmetic surgeon, as well as Michelle Sieffert, MD, a board-eligible plastic surgeon based out of Donaldson Plastic Surgery℠ in Ohio.

Cheek Filler Fact #1: Your facial structure begins to change as you age.

“We all start to get bone resorption and displacement of fat pads in the face starting around age 30,” explains Dr. Jerdan. These fat pads, which are responsible for the face’s volume, begin to thin out and descend. This can make a face appear as if it’s sagging. In my case, this descent started a bit earlier: my practitioners pointed out the exact, visible edges of the drifting fat pads in my cheeks, making me a particularly good candidate for filler. 

“Cheek filler is used to recreate [volume to look like the lost] structure underneath, and create an ‘ogee curve,’ which is the curvature seen typically in [youthful] faces, giving the upper- and mid-face fullness and width,” she says. Want a visual on an ideal ogee curve? Dr. Sieffert cites Natalie Portman, Angelina Jolie, and a high percentage of Victoria’s Secret® models as solid examples.

Cheek Filler Fact #2: Cheek filler can also be used just to add volume to your given cheekbone structure.

In other words, fat pad displacement isn’t the only qualifier. “Face shape is determined by a combination of a person’s bone structure, facial musculature, and facial fat distribution,” says Dr. Sieffert. “The bone structure of the face is just as important as the fat pads in contributing to the shape of the face.” With injectable filler, your provider can add volume along your existing cheekbones to make them more pronounced and defined. 

“There are other strategic areas for cheek filler that can help [you] globally have a more enhanced apple of the cheek, such as the lateral cheekbone,” adds Dr. Jerdan. Our advice: Work with your provider to get to know your natural structure and figure out the best areas of treatment for you.

Cheek Filler Fact #3: The sensation of the injection can be a bit weird.

It wasn’t the pain, but the location, feeling, and even the sound of it — a crackly, popping sensation along with the distinct pressure of the filler being pushed beneath the skin — that surprised me the most. It alarmed me so much during my first cheek filler experience, I had to take a break halfway through. (Which is totally okay to do, by the way! Discover some of my tips for staying calm during an injectables appointment here.) 

The reason for that has to do with needle placement. More often than not, your practitioner has to place the needle fairly deep — which can feel, uh, odd. “Nine times out of ten, cheek filler is necessary due to suboptimal bone structure, and I can help add lost volume back,” says Dr. Jerdan. But that also means taking other anatomic considerations, like nerve placement, into account. “Yes, it does sound weird,” she agrees. “Because I [have to] make sure my needle is in the proper place when I inject to avoid important vasculature and nerves that can be damaged otherwise.” Those movements of the needle can sometimes make sounds.

Cheek Filler Fact #4: Start slow and build from there.

In my experience, I’ve found that the best way to get your desired results with filler is to err on the side of subtle treatment, and then work with your provider to add more volume as you see fit. After all, most providers will advise working with the look of your existing bone structure, rather than creating something that wasn’t there to begin with.

“It's important to not overfill the cheeks, as it can be alienesque,” warns Dr. Jerdan. “It’s best to try to keep with the natural architecture of your own face. The best results are those that are gradually developed — and if you’re someone who doesn’t want anyone to know that any work was done, then this is absolutely the best way.” And I’m definitely that someone.

Complimentary treatment was provided to the author for the purpose of writing this article.