Ask the doctors

September 1, 2008

Questions about cheek augmentation and Botox safety

I'm considering cheek augmentation with either implants or fillers, and wonder, is one better than the other?

Dr. Niamtu: Midfacial rejuvenation is one of the most commonly overlooked areas in cosmetic facial rejuvenation. Contemporary cosmetic practitioners offer numerous options to make the midface appear more youthful.

Cheek implants and injectable fillers are two popular options for midfacial augmentation, and both have pluses and minuses. Injectable fillers are quick, easy, nonsurgical and without significant recovery. They can give the patient an immediate result and can be a "trial" for more permanent options. The downside with fillers is their temporary nature, the requirement for an experienced injector and the cost compared to more permanent methods.

Both of these techniques have a place in contemporary cosmetic facial surgery, and are a compromise between the experience of the surgeon and the desire of the patient.

If the patient is conservative and anxious about a surgical option, then filler treatment would be a good alternative.

For those patients committed to a permanent surgical option, cheek implants represent a safe, predictable, affordable and reversible plan to rejuvenate the midface.

Is Botox safe? I heard from a news report there are some concerns about it.

Dr. Schlessinger: The simple answer is unequivocally YES, it is safe for cosmetic concerns.

The news media has forgotten to explain that the Botox concerns were with patients where huge amounts (100 times the amount that we usually inject for cosmetic concerns) were used. Additionally, these patients were sick to begin with, as it was used on very ill patients with cerebral palsy and other conditions.

Cosmetic Botox, when used in the usual doses (less than one bottle of Botox), has an unparalleled record of safety with over 25 years of use and millions of injections with no problems.

Sadly, there is a bias in the general media against cosmetic concerns and the majority of articles don't go over the benefits that these procedures can provide for patients when used correctly.

As always, I recommend that anyone who is considering these procedures go to a "core specialist" such as a dermatologist, plastic surgeon, ENT/facial plastics or oral maxillofacial specialist for their procedures. It is also my bias that if you are undergoing a procedure such as Botox or fillers, it should be performed by the physician and not a nurse or "extender."

The more experience the doctor has doing these procedures, the better they are, and this translates to better and safer results for the patient.