Upper Cheek Wrinkles Lower Cheek Wrinkles Cheek CrÍping
In this section, we will discuss how physicians are using advanced liquid face lift products, including dermal fillers, such as JUVEDERM®, Radiesse® and Restylane®, as well as BOTOX®, to correct various types of wrinkles on the cheeks. We will break the wrinkle conditions into three categories for simplicity.
First, we will discuss wrinkle correction for wrinkles that extend from the crows feet down and out over the lateral cheek bone (zygomatic arch) area. Secondly, we will discuss wrinkle correction for lower and mid face cheek wrinkles that extend up from around the jaw line over the cheek hollow (sub malar) region of the face. The cheek hollow area is basically the flat area on either side of the face, extending above the jaw line to the cheek bone. Finally, we will discuss wrinkle correction for wrinkles that emanate from more than one location or direction, and sort of cross hatch on the cheek hollow. The cross hatching of numerous wrinkles can also create a creping affect, similar to crÍpe paper.
Before dermal fillers are applied, most healthcare providers will numb the areas to be treated with a topical anesthetic, local anesthetic or nerve block, depending upon the area to be treated and physician’s preference. Also, ice is often used during and after the procedure to help control any swelling.
Note: Before undergoing any procedure discussed on this web site, make sure that your doctor has extensive experience with the specific procedure. Medical schools have only recently begun to teach some of these procedures. As with any medical procedure there are varying degrees of risk involved. Please consult your physician.
Upper Cheek Wrinkles
Wrinkles around the outer corners of the eyes are commonly called crow’s feet. Crow’s feet wrinkles in some individuals can elongate over the cheek bone and onto the cheek hollow. These lines are generally superficial and relatively shallow. To treat these lines, dermal fillers such as JUVEDERM® Ultra and Restylane® are typically combined with BOTOX® to fill and relax the wrinkles.
BOTOX® is injected in the depressor muscles somewhat above and outside of the eyes and out along the zygomatic arch (cheek bone area). Dermal fillers are placed beneath the wrinkles, usually in the mid dermis of the skin.
In this area of the face, the wrinkle reduction will typically endure longer than some other facial areas because there is less movement. Some physicians report that they have treated patients for upper cheek wrinkles with the liquid face lift products mentioned above, and after a few treatments, have seen these wrinkles disappear for significant amounts of time.
Lower Cheek Wrinkles
Some individuals have wrinkles that arch up the cheek hollow from around the jaw line. Wrinkles in this area are commonly treated with a dermal filler such as JUVEDERM® Ultra or Radiesse®.
For more shallow wrinkles, a product like JUVEDERM® Ultra is an effective product that may last up to a year, particularly in this part of the face. Radiesse® is an excellent product for deeper wrinkles as it not only helps initially fill & lift deeper wrinkles, but it works to stimulate the body’s own collagen for some enduring results. Some physicians will use Sculptra® in the cheek hollows as well. Sculptra® is FDA approved for areas that have lost volume or atrophied. It does not fill, but over time stimulates collagen growth. This in turn has a positive effect on diminishing wrinkles. Depending upon the origin and placement of the wrinkle, some lower cheek wrinkles may be treated with BOTOX® as well. Some physicians use a combination of these products, depending upon the patient’s needs and goals.
On the flat plane of the cheek hollows sometimes wrinkles not only arch vertically from the cheek bone or the jaw line (or both), but also emanate out horizontally from the middle of the face. This can occur when an individual has experienced a significant amount of collagen break down and loss of elastin. Some patients develop skin that looks a bit like crÍpe paper.
Dermal fillers cannot only diminish or eliminate the wrinkles, but often work to smooth the skin as well. Over time, most patients will notice a marked improvement of the skin’s texture in the treated areas. Maintaining the correction, over time with periodic treatments, will likely cause the patient to need lesser amounts of filler as the body responds by creating collagen.Contributing Physicians:
W. Grant Stevens MD FACS, Marina Del Rey, CA ~ D. Scott Karempelis M.D., Atlanta, GA
Dennis J. Hurwitz MD, Pittsburgh, PA ~ Dan L. Bennett MD, Overland Park, KS
Harrison Putman III MD, Peoria, IL ~ Lisa M. Donofrio MD, New Haven, CT
Tahl Humes M.D., Denver, CO ~ Anna Pare MD, Atlanta, GA