Filling the cheek with 3 cc of volume failed to demonstrate lateral traction on the intervening skin from the cheek injection site to the nasolabial crease, according to a recent study in Plastic and Reconstructive Surgery.
“It has been stated from numerous publications and podiums that filling the cheeks elevates the nasolabial fold, without any evidence,” says lead author Val Lambros, M.D., a clinical professor of plastic surgery at the University of California, Irvine. “But if this is true, then injecting the cheeks should cause a pulling force on the fold.”
All 77 female study patients first had 1.5 cc of local anesthetic injected into their cheek to determine if they liked their look. Afterward, 1.5 cc of the hyaluronic acid filler Juvéderm Voluma (Allergan) Voluma was injected, thus doubling the intended amount of filler.
A three-dimensional camera system was used to detect a difference between the cheek and nasolabial fold.
“All patients showed a pattern of expansion, dots and pores on the face that were spread apart and not pulled toward the center of the injection,” Dr. Lambros tells The Aesthetic Channel.
In a subgroup of 37 patients who had had no difference in expression by motion of the nasolabial fold or base of the nose, as in a slight smile, “there was no pull of the tissues between the cheeks and nasolabial crease,” Dr. Lambros says. “In other words, there was no traction of the skin between the cheek and the nasolabial fold, hence any appearance of improvement is illusory.”
Dr. Lambros is not surprised by any of the study results. “It seemed unrealistic to suppose that the small amount of filler injected would pull the skin of the face,” he said. “But perhaps if ping pong balls were injected, there might be a difference.”
Cheek filling has falsely been marketed to patients as an effect that "lifts" the face, according to Dr. Lambros. “Filling expands. It does not lift,” he states.