What Is The Best Injectable Filler For Facial Hollowing?

Q: Dr. Eppley, I had my buccal fat pads removed over 10 years ago which looked great. Then I lost a considerable amount of weight, over 50 lbs, and now look too sunken in. What is the best filler used to replace where buccal fat pads have been removed?

A: The answer to your question partially depends on how much volume is missing (how sunken in you are) and what method (surgical vs non-surgical) you want to pursue. But using the injectable filler criteria as your question posed, I will answer based on that one variable only. Because of the volume of the buccal fat pads (usually 5 to 10cc per side), the best replacement filler is fat injections. While the injection of fat is unpredictable, it offers an unlimited amount of volume for facial injections and it has the potential for some permanent volume retention. While there are many proponents for the various synthetic injectable fillers that are currently available, one has to recognize the cost of the volume needed per side based on the volume lost and that none are permanent. But if one had to go for a synthetic injectable filler, I would first use one of the longer-lasting hyaluronic acid fillers, like Perlane or Juvederm, to see if you like the effect. While there are longer-lasting fillers, such as Sculptra, Radiesse and Artecoll, they can be associated with higher risks of lumpiness and irregularities than the non-particulate hyaluronic acid-based injectable fillers when it comes to larger volume augmentations.

Dr. Barry Eppley

Indianapolis, Indiana