The ideal cheek filler is one that provides strong support and lift without looking unnatural, one that lasts for a long time, and one that is reasonably priced.
Fortunately, we have several filler options to choose from.
Why fill the cheeks?
Our face changes in several ways as we get older. In particular, we lose volume especially in our cheeks. Our facial volume is mainly from our skull and the fat in our face.
As we age, our skull changes and we lose fat in our face.
So, one of the ways we can reverse this sign of age is to replace some of that lost volume with cheek fillers.
Each of these dermal fillers has unique advantages and disadvantages.
Voluma, Restylane Lyft, and Radiesse all directly replace volume where they are injected. Meaning that except for bruising and swelling that occurs from injection, results are usually seen immediately.
Sculptra is unique in that it is a bio-stimulatory agent. Sculptra adds volume by stimulating collagen production. As collagen is stimulated and grows, it replaces lost volume. Once enough collagen is produced, you see results. Thus, results take a few months to be seen.
An important point is that the other fillers mentioned above also stimulate collagen. Although, they don’t rely on this effect to see results.
Lift and support
Voluma, Restylane Lyft, and Radiesse all provide strong lift and support. They are thick products that hold their shape reasonably well once injected.
To illustrate, if any of these cheek fillers were squirt out of a syringe into a pile, they would hold their shape well and not spread into a puddle.
Sculptra works a little differently. It does not provide lift and support. However, it is still an excellent choice for many people.
Sculptra adds volume by stimulating collagen growth in that area. It can be injected over a larger surface area. Thus, Sculptra is a good choice when a larger area such as the full cheek and temples need filling, and this is it’s main advantage.
Cost and value
Instead of thinking about cost in determining the best cheek filler, it’s important to consider value. By value I mean, answering the question, “what is the most cost-effective way to achieve the results you want?”
The factors that go into value are the price of the syringe of filler, how likely the cheek filler will be successful in giving you good results, and how long those results will last.
Let’s talk about how likely the filler will be in giving you good results first. The bottom line is that there is no point in doing any treatment if it won’t get you the results you want.
With cheek fillers, almost everyone is likely to get at least decently good results from Voluma, Restylane Lyft, or Radiesse for replacing localized volume loss. However, everyone metabolizes fillers differently, so some people’s body will do better with one filler versus another.
For those people with larger areas of volume loss, Sculptra is often the best choice.
Price per syringe
The price of a syringe of filler is another important factor in determining the cost.
Fillers are priced by the syringe in the case of Voluma, Restylane Lyft, and Radiesse. Sculptra is priced by the bottle.
Generally, the price per syringe (or bottle) is a little higher for Voluma and Sculptra than for Radiesse and Restylane Lyft. In our office, Restylane Lyft is the least expensive option per syringe.
The cost per syringe is only one part of the equation, though.
You also need to consider how many syringes you will need to use.
To illustrate, Radiesse is more expensive than Restylane Lyft, but one syringe of Radiesse is equal to 1.5-2 syringes of Restylane Lyft in terms of the amount of volume and lift it provides.
Lastly, how long a product lasts also factors into the overall value.
Sculptra typically lasts 2 or more years. In clinical trials, Voluma provided lingering improvement in a reasonable portion of patients for up to two years after injection.
In reality, Sculptra usually lasts the longest, followed by Voluma, Restylane Lyft, and Radiesse.
The best cheek filler
We’ve discussed that multiple factors go into identifying the best cheek filler option.
The bottom line is that the best choice is not the same for everyone.
For those needing a large area of volume replacement (such as those who have a gaunt appearance), Sculptra is usually the best choice.
Incidentally, Sculptra is often an excellent choice even for people who do not have a wasted appearance. It creates a nice foundation to combat the early stages of volume loss.
In patients where we are filling a localized area of loss such as a flattened central cheek, or in patients where we are replacing lost support on the lateral cheek bone, one of the other major fillers is usually the best choice.
Picking the best cheek filler depends on how you have responded to that filler in the past and the extent of the current budget.
One important point to remember is that facial rejuvenation is not a one time event. So if you need multiple syringes to replace lost volume, you don’t have to do them all at once.
You can start with a certain amount and add more over time until you get to your ideal, natural appearing correction.
In fact, sometimes it is better to take this approach – start with a a syringe or two, and add more over time if needed.