What is cheek dermal filler?
Cheek dermal filler is the procedure in which the tissue support in the cheek area is assessed and, where considered suitable, a dermal filler product containing hyaluronic acid is delivered into the area.
The product used is a medical device (opens in a new tab), and in Türkiye medical devices are monitored through the Product Tracking System (ÜTS) (opens in a new tab).
Two things to know first:
1. The risk of vascular occlusion. If the product enters a vessel or presses on a vessel, tissue damage may develop in the area supplied by that vessel. The upper part of the cheek area is adjacent to the region around the eye; for this reason a change in vision is also among the situations reported. It is rarely seen, but it requires intervention within hours.
2. This area also affects the appearance of the neighbouring areas. The tissue support in the cheek area is related to the appearance in the under-eye and nasolabial areas. For this reason, the three areas are assessed together at the consultation.
The limit of expectations: An excessive amount of product is the most frequently reported problem in this area; widening of the area, a feeling of heaviness and an unnatural appearance may occur. The amount is determined not by a target appearance but by what the tissue can carry.
Dr. Suzan Alp, Specialist in Internal Medicine, performs the procedure at the practice (opens in a new tab).
Which factors determine whether the procedure is suitable?
The decision on suitability is made at the end of the consultation. The following factors are decisive in the assessment:
- The state of the tissue support and volume in the cheek area
- How the appearance relates to the under-eye and nasolabial areas
- The thickness of the skin, the degree of laxity and the skin’s capacity to recover
- The existing symmetry between the two halves of the face
- Whether there is a tendency to oedema
- Dermal filler previously applied to the area: its type and when it was given
- Which medicines are being used, and whether there is a bleeding tendency
In which patients is the procedure not performed?
- In patients with a history of allergy to the product to be used or to its components
- In patients with a history of allergy to the dissolving enzyme (intervention would not be possible if it were needed)
- In pregnant and breastfeeding patients
- In patients under 18 years of age
Situations that require separate assessment
- Bleeding or clotting disorder, or use of blood-thinning or anticoagulant medicines
- Active infection or febrile illness (the procedure is postponed)
- Autoimmune disease in an active phase (the opinion of the relevant specialist physician is obtained)
- Treatment that suppresses the immune system (the opinion of the relevant specialist physician is obtained)
- Uncontrolled diabetes (healing may be affected)
Additional conditions specific to this area
The procedure is not performed if the following are present in the area to be treated:
- An active infection, an acne lesion or an open wound
In these situations, the procedure is planned subject to the physician’s assessment:
- A non-absorbable type of dermal filler previously applied to the area (the opinion of the relevant specialist is sought)
- A marked tendency to oedema (the area is adjacent to the region around the eye; the cause of the oedema is assessed first)
- Marked facial asymmetry (it is discussed in advance that it may not be corrected completely)
- A history of facial palsy (the opinion of the relevant specialist is sought)
- A tendency to keloid or hypertrophic scarring (a raised scar that spreads beyond the original wound)
If dental treatment has recently been carried out or is planned, the procedure is postponed.
How is the procedure performed?
- Assessment. The tissue support in the cheek area, the thickness of the skin and symmetry are assessed; its relationship with the under-eye and nasolabial areas is considered at the same time. Tendency to oedema, previous dermal filler procedures and their type, and the timing of dental treatment are asked about. Any history of allergy, bleeding tendency and current medication are recorded. Blood pressure and pulse are measured.
- Product check. The ÜTS registration, packaging integrity and expiry date of the product to be used are checked. The dissolving enzyme must be available where the procedure is carried out.
- Information and consent. The procedure, the risk of vascular occlusion, the possibility of a change in appearance as a result of an excessive amount of product, asymmetry and possible side effects are explained in writing and verbally; the form is signed. The symptoms for which help should be sought without delay after the procedure are given in writing.
- Preparation. There must be no make-up on the area. Antisepsis is ensured.
- Application. The product is delivered into the intended layer, in a measured amount.
- Observation and follow-up. The patient is kept under observation after the procedure; vision and the area are checked for signs of vascular occlusion. Vital signs and observations are recorded in the file. A follow-up appointment is arranged.
When is the effect seen, and how long does it last?
The appearance seen in the first few days is not the final result; the swelling is allowed to subside before the result is assessed. The width seen in this area in the first few days may be due to swelling.
The effect is temporary. The product used is absorbed over time; the duration varies from person to person, by area and by product, and cannot be stated in advance.
What should you do before and after the procedure?
Before the procedure, report:
- A list of all the medicines and supplements you use (in particular blood thinners, painkillers and herbal products)
- Your known allergies
- Your pregnancy and breastfeeding status
If you have had dermal filler in this area before, state when it was given and of what type.
Come with no make-up on the area.
After:
- Swelling and bruising are to be expected
- The area must not be massaged or rubbed
- You are asked to avoid sleeping face down and putting pressure on the area for a period
- If you wear glasses, you are advised to make sure they do not press on the area
- The period given for hot environments, saunas, sunbeds, swimming pools and intense exercise must be observed
- You are asked to keep the written list of warnings you are given
Recommendations and time periods specific to you are given in writing at the end of the procedure.
Risks and side effects
Requiring urgent assessment
- Vascular occlusion. The signs: pain that is more severe than expected and increasing, blanching of the skin, a purple-red change in colour in a net-like or spotted pattern, coldness of the area, and crusting and sores at a later stage
- Loss of vision or a change in vision (rarely seen; the upper part of the area is adjacent to the region around the eye)
- Tissue loss in the skin (necrosis)
- Infection and abscess at the site of the procedure
Other risks specific to this area
- Asymmetry (frequently reported in cheek dermal filler)
- Widening, a feeling of heaviness and an unnatural appearance as a result of an excessive amount of product
- The area becoming more marked, or looking different, when smiling
- Displacement of the product over time (downward slipping has been reported)
- Firmness, irregularity or a nodule that can be felt by hand
- Swelling under the eye (the product may retain water in the cheek)
- The expected change not being seen (where skin laxity is the prominent finding, the result is limited)
General risks that may occur with any minor procedure
- Swelling, bruising, pain and tenderness
- Temporary change in sensation
- Allergic reaction
- Swelling and redness appearing at a late stage
Results vary from person to person. No guarantee can be given as to a result or a duration.
When should you see a physician without delay?
If you experience these symptoms during treatment, contact your physician without delay:
- Increasing redness, increased warmth, swelling or discharge in the area
- A high fever
- Crusting or the formation of sores on the skin
- Widespread rash, itching
In the event of pain that is more severe than expected and steadily increasing, blanching of the skin, a purple-red change in colour in a net-like or spotted pattern, or coldness or paleness of the area, contact your physician at once; if you cannot reach them, go to the nearest emergency department. In the event of any change in vision, or rapidly increasing swelling of the lips and eyelids, go directly to the emergency department.
Frequently asked questions
What is the problem most frequently encountered with cheek dermal filler?
It is a change in appearance as a result of an excessive amount of product: widening of the area, a feeling of heaviness and an unnatural appearance. For this reason, the amount is determined not by a target appearance but by what the tissue can carry. Asymmetry is also among the situations frequently reported for this area.
Does cheek dermal filler affect the area under my eyes?
Yes, the two areas are adjacent. In this area the product may retain water, and swelling under the eye has been reported. For this reason, your tendency to oedema is assessed before the procedure, and the two areas are considered together.
My cheeks are uneven — will this be corrected completely?
The two halves of the face are not naturally identical, and existing asymmetry may not be corrected completely. Asymmetry is also among the situations reported after the procedure; this possibility is discussed before the procedure.
Does dermal filler slip downwards?
Displacement of the product over time is among the situations reported; for this area, downward slipping has been reported. This is assessed at the follow-up consultations.
Are cheek dermal filler and nasolabial dermal filler carried out together?
The tissue support in this area is related to the appearance in the nasolabial area; the two areas are assessed together at the consultation. Which of them is to be performed, and to what extent, is decided accordingly; Nasolabial Dermal Filler is described on a separate page.
How long does the effect of cheek dermal filler last?
The effect is temporary; the product used is absorbed over time. The duration varies from person to person, by area and by product, and cannot be stated in advance.
Is cheek dermal filler performed during pregnancy?
No. The procedure is not performed during pregnancy or while breastfeeding.
Sources
- Ministry of Health of the Republic of Türkiye, Turkish Medicines and Medical Devices Agency, Tıbbi Cihaz ve Ürün Takip Sistemi (ÜTS). https://www.titck.gov.tr/faaliyetalanlari/tibbicihaz (opens in a new tab)
- Ministry of Health of the Republic of Türkiye, Turkish Medicines and Medical Devices Agency, Tıbbi Cihaz Yönetmeliği, Official Gazette 2 June 2021 / 31499 (repeated). https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=38657&MevzuatTur=7&MevzuatTertip=5 (opens in a new tab)
- Ministry of Health of the Republic of Türkiye, Ayakta Teşhis ve Tedavi Yapılan Özel Sağlık Kuruluşları Hakkında Yönetmelikte Değişiklik Yapılmasına Dair Yönetmelik, Official Gazette 7 January 2025 / 32775. https://www.resmigazete.gov.tr/eskiler/2025/01/20250107-3.htm (opens in a new tab)
