Question: If I have injectable fillers in my midface and cheek area, how long should I wait before I can safely have a midface lift?

Answer: You really do not have to wait to have a midface lift after having fillers placed in your midface, but obviously if you have gotten a nice result from your fillers, you might want to enjoy them and then get the midface lift once they have resorbed.  If the timing is good for a midface lift surgery and the fillers are unnecessary after the surgery then hopefully you have had hyaluronic acid fillers placed in your midface and your surgeon can simply place a small amount of hyaluronidase in the area a few days before surgery to literally make the filler completely disappear prior to the surgical procedure.  Ultimately, I feel this is a rather individualized and customized approach, and I would just discuss your concerns with your surgeon.

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Question: How do you avoid “pillow face” with injectable fillers?

Answer: The answer to that question is simply do not overuse the fillers and place them in an appropriate location. This, unfortunately, comes with experience and expertise as well as artistry and that is why I always recommend that patients seek out a very experienced injector to make sure that they get the result that they want since filler placed in too low of a location on the cheek can sometimes give patients an overly full appearance while that same amount of filler placed up higher in the cheek can frequently give people a more aesthetically pleasing result. With that said, there are patients who have very strong cheekbones and if the filler is placed too high then they actually look strange and if it is placed lower in the face, this balances out their full cheekbones and gives them a more youthful appearance. I know that sounds a bit confusing but, ultimately, there is a significant amount of artistry involved with facial fillers and that is really why a very experienced injector is necessary to give patients the appearance that they desire.

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Question: I am a lifetime smoker planning to get fat injections into my smile lines. Will my habitual smoking affect the longevity of my fat injections?

Answer: I have personally not seen any good studies at this stage showing any decreased viability of injected fat into smokers versus nonsmokers, so I am not sure I can scientifically answer that question but, for the most part, I do not feel that smile lines are very successfully treated with fat grafting at least not in the long term. I usually steer my patients toward an injectable filler material such as hyaluronic acid for a temporary, but very significant, improvement in these lines.

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Question: If I want a procedure that will give me the appearance of having higher cheekbones what would be my best option?

Answer: You have several options to give the appearance of higher cheekbones. The easiest would be simply to place filler high up in the cheek and add volume in this area and this will, therefore, make your cheeks more prominent. A longer lasting possibility would be to place cheek or malar implants so that this volume will last a lifetime. A third option would be a midface lift, which is a surgical procedure that lifts the cheek tissue up into a more aesthetic position, and a final option would be a deep plane facelift where the midface is elevated in conjunction with a very elegant facelift.

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Question: If I am allergic to dermal fillers, is it safe to do a fat transfer?

Answer: Yes, if you were theoretically allergic to dermal fillers, fat transfer would still be extremely safe since it is from your own body and you, therefore, cannot be allergic to your own fat.

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