Loss of volume in the mid face can be very aging. Most people will experience a change in this area as they age. Hollowness of the cheeks can be a feature of recent weight loss.  When there is loss of volume in this area, lines can appear in other areas.  For example, very hollow cheeks can result in pronounced Nasolabial lines. It can also result in jowls as the skin that the cheeks used to hold up has fallen dow

What you should know

The best way to treat volume loss in the cheeks is by deep volume replacement. Filler is added to the lateral(outer cheek) and anterior(beside the nose and under the eye) aspects of the cheek.  The lateral injection of product will pull the skin out to the sides and the anterior injection will round out the cheeks in the front.  The amount of filler needed depends on the persons age, volume loss and personal requirements.  Unfortunately in hollywood, we have seen some examples of overestimation of the amount of filler required.  Puffy cheeks are the result of this.  Usually this is by serious overestimation of the required amount, of the order of double or triple what is needed.

Treatment takes about 5 minutes and is done via two injection points on each cheek.  The cannula technique of injection results in very short downtime and minimal, usually no bruising!

The cannula technique is a relatively new way of injecting dermal fillers. Instead of a sharp needle that can damage tissues and cut through blood vessels, a blunt cannula is used. This hollow needle-shaped blunt instrument can be used to deliver product where it is needed to restore volume, but without causing any bleeding other than that at the initial entry point of the cannula.  Pain is minimal and usually rated as 1/10 compared to 3-6/10 for fillers via a needle.

The side effects associated with treatment in this area are minimal.  Common needle side effects include temporary (5-10 minutes) swelling and redness, less commonly bruising, and then much less commonly again, product specific side effects which your doctor will discuss with you before treatment.   A needle must be used to introduce the cannula so there may be a spot on each cheek which must be kept clean for a day or so to avoid infection. Also there may be some cheek tenderness for 48 hours after treatment. Over the counter pain killers can combat this discomfort.