The Plastic Surgery Channel

Nose, Boob, and Neck Jobs, but Don’t Forget the “Cheek Job”


You’ve heard of a nose job, a boob job, and maybe even a neck job, but a cheek job? Perhaps not too surprising is the fact that aging of the “cheeks” is where visible aging first begins. Often facial aging is blamed on the ever-present downward pull of gravity, but really the loss of volume in the face is what really creates gaunt and “droopy” skin.

A “cheek job,” or a mid-face lift, addresses this volume loss in order to rejuvenate the face. Board certified plastic surgeons share the various techniques they utilize to impart significant aging reversal in one of the hardest hit areas of the face.

Different Approaches, Same Goal

Fortifying weak cheek structures can make a huge difference when you’re trying to regain a youthful appearance. Sunken cheeks often take away from even a well-defined facial structure, and naturally occurs as we age. Whether you choose temporary injectables, or a surgical option to restore volume, today’s technologies deliver the prominent, balanced facial features you used to have. Improvement can be made alone, or in combination with other facial improvement, such as eyelid surgery.

“There’s lots of things we can do to cheeks,” says board certified plastic surgeon Anu Bajaj, MD of Oklahoma City. “So you think about it, when we’re younger, we had round full faces, but as we get older, we lose fat and volume in our faces, and that’s where fillers can help augment your cheeks. One [surgical] option is a cheek implant. Another option is fat grafting.”

Are Cheek Implants Still Viable?

While breast implants are a mainstay in breast augmentation, thanks to being the most studied medical device in history, implants in other areas of the body can cause problems. More to the point, better solutions have been discovered and are now utilized.

Board certified plastic surgeon Dr. Jason Pozner has used cheek implants in the past, but prefers more modern technology that promises less risk. “Back in the day, when I was starting my training, we were doing a lot of cheek implants,” he tells The Plastic Surgery Channel. “Lots can go wrong with that. They can get infected. You can have problems with the bone. They can migrate. I haven’t put a cheek implant in in years, and years, and years.

“I really would caution someone against an implant unless they had maybe a facial fracture or something else where they actually had a really bad deformity of their cheeks,” Dr. Pozner warns. “The mainstay for higher cheeks is either fillers or fat grafting.”

THE Most Popular Fix for Fuller Cheeks: Fillers

Facial fillers are often grouped in the category of “injectables” alongside the neurotoxins, the most famous of which is Botox. The neurotoxins are meant to “stun” facial muscles to inhibit wrinkles from forming, or to lessen those already present. Fillers, on the other hand, do what their name suggests: fill. They are temporary yet powerful products that add back the lost volume that contributes mightily to an aged face.

Dr. Christine Hamori, a board certified plastic surgeon in Duxbury, MA, loves the impact fillers have on her patients. “There are a lot of fillers that have a high G prime; they’re very thick,” Dr. Hamori tells The Plastic Surgery Channel. “They can be placed in that area to help [volume loss]. We always deflate around this part of our face, so definitely that’s one way.”

Again, fillers are a temporary fix, but this may be all that a patient requires at this stage of their life. Additionally, women AND men can benefit from fillers. Dr. Bajaj notes her husband has loss of volume in his face that would greatly benefits from fillers. “I’m going to do fillers on my husband,” she shares. “His cheeks are hollow and saggy!”

It’s important to note that there are significant differences between men and women in terms of facial anatomy. This is why it is critical to see a board certified plastic surgeon, even when “just getting fillers,” as their history with surgery and facial anatomy provides the knowledge to place fillers appropriately in both men and women. “We place it in different areas because you want different highlights for men and women, but definitely, yes, men love it,” Dr. Hamori shares.

Beyond Fillers: Fat Grafting to the Face

If fillers aren’t getting the job done anymore, or a patient is looking for more of a permanent fix, there is a surgical solution without cheek implants: fat grafting. This procedure is one of the hottest in modern plastic surgery and is used all over the body to “shift” volume created by fat where it’s unwanted to where it is needed. Fat grafting works by removing fat from an area with liposuction, then injecting that removed fat to other areas that need volume.

In terms of the cheeks, surgeons will remove a small amount of fat from an abundant area with liposuction then inject that fat into the face. The result is “more natural” than an implant, since the patient’s own tissue alone is being utilized.

For Dr. Pozner, this is his mainstay when it comes to a surgical cheek improvement option. If his patient requires more than fillers, or if he’s already operating on them for a complimentary procedure, then utilizing fat grafting to the cheeks is a great option. “If I’m in the OR doing a facelift, I tend to drift towards fat grafting, a more permanent result,” he shares.

Fillers or Fat, The Options are Tremendous

While fat grafting continues to gain steam through success, there is no doubt that fillers offer a great, easily-achieved rejuvenation to the face. Patients who are middle-aged can achieve significant rejuvenation simply by having fillers injected in an office-based procedure that takes hardly any time at all. For many, regular filler injections could provide them with a decade or more of rejuvenation, or slowed-down aging, before surgery is ever on the table. When that time comes (and it will for all), fat grafting is an incredible option to help patients age gracefully.