Dr. Dean Kane Q & A 
Q. How can I get defined cheekbones without surgery? I want to get higher cheeks and get a defined cheekbone, can I get that with Botox?
A. Botox is a muscle relaxer and if placed in the cheek area can cause cheek and upper lip drooping and lower eyelid weakness.
Cheek augmentation, filling, structure, firming and contouring are achieved minimally invasively with a variety of Fillers. In my experience:
- Radiesse, a bone mineral-like filler may be used to elevate and add support of a “weak” or hypoplastic cheek bone; both under the eye and along the lateral face and has lasted 2 years or more.
- Fat which needs to be obtained or harvested from another site provides volume to fill an area when it properly survives. That fat which survives 3 months generally survives forever.
- Sculptra, a bio-stimulant does not add volume nor projection but is a particle which stimulates a skin response to form more hydrating and structural molecules firming and shrinking the skin. It may also stimulate other tissues such as surrounding fat and bone to grow.
- HA (hyaluronic acid) fillers are chains of molecules which attract water for a duration of 6 months to 2 years. The synthetic linking which binds these chains together determines the many properties of each product including its flow or silkiness, the amount of water attraction, its ability to stack or project and its duration. These include products such as the Juvederm family and the Restylane family of HA gels. Natural human enzymes in the skin will breakdown the molecules and reduce the water retention. Likewise, injectable enzyme may be used to more quickly dissolve the gel if it is unwanted.
- Non-biodegradable injectable fillers are also available for cheek and other areas of fill.
Depending on the cheek bone deformity, a variety of harder substances acting as a scaffold may be inserted surgically to further define the cheek including bone.
Due to the variety of options and the advanced techniques of assessment, injection, layering and skills required, I recommend you consult with a artsy and talented, Board Certified Plastic Surgeon or ENT Facial Surgeon to review what is best for you!
Happy Holidays! I wish you the best.
