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Treatment Of Stubborn Cheek Wrinkles

Posted: 52:52 p.m. Friday, Feb. 23, 2018

By Anita Mandal, M.D.
Question: I have deep wrinkles over my cheeks. In my 60’s, I used to get Juvederm which improved my wrinkles. In my 70’s, I finally lost 25 pounds and while I feel better at my new weight, my cheeks are hollow and the cheek wrinkles look worse. Juvederm doesn’t seem to work anymore. Is there a treatment that will help my deep cheek lines?

Answer: Based on the description of your situation, it sounds like with the weight loss, you also lost volume in your face. As your cheeks hollow, the wrinkles over the cheek tend to get deeper.

A superficial filler like Juvederm isn’t working anymore because your cheeks are “deflated”. Think of what happens to a balloon which loses all of its air. Not only does it shrink, but it also looks more shriveled up. Similarly when you lose volume in your face, new wrinkles can appear and existing wrinkles can deepen.

Just like filling a balloon with more air will eliminate the “shriveled” look of the balloon, volumization of the cheeks can not only improve the hollows but also soften and improve overlying wrinkles.

Your filler options include Sculptra, Voluma or Restylane Lyft. However, these temporary filler go away in a year or two unless you do regular and costly maintenance treatments. My filler of choice for situations similar to yours is Bellafill.

Not only is Bellafill safe and very natural looking, but it’s also the most cost effective since it lasts 5 years. Using the micro-cannula, Bellafill injections of your cheek hollows can not only give your cheeks volume and some natural fullness, but also help flatten your deeper wrinkles.

Another trick that I use in situations such as yours is where I pass the injection micro-cannula into the superficial cheek tissues just on the undersurface of the wrinkles. This technique actually causes additional stimulation of collagen to further improve the wrinkles. Combining cheek volumization by injecting deep within the tissues along with a superficial injection on the undersurface of the wrinkles can be a very effective approach in situations such as yours.

Such advanced micro-cannula injection techniques should ideally be performed by a Board Certified Facial Plastic Surgeon. A surgeon who is not only an expert injector but also understands the complex facial anatomy and facial changes occurring with age is the most qualified to give you optimal results.


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