Dr. Sam Lam Plastic Surgery Forum

Hi Dr Lam,

I had buccal fat removal a while ago and I hated the result, it was my worst nightmare. I wonder what would be the best filler to fill up the buccal area beside the nostril and above the corner of the mouth on each cheek. Which one works best in your opinion: Voluma, Restylane Q, Radiesse? I have no fat to do fat transfer and I am afraid of Sculptra's nodules. I am in my 30s.

Thanks.

restylane q is not approved in the U.S. and most likely will not be due to problems of migration seen in Canada. i think voluma is in a similar boat. radiesse, perlane, and sculptra are all three good choices. sculptra in a highly static zone like the buccal area in the right physician's hands and with the right dilution should have limited risk for nodules. i think sculptra around the eyes and around the mouth is a different story. i personally do not use sculptra right now because of the limited indication for only midfacial volume is too narrow for my taste but that might work in your situation. there is no "perfect" filler.
best,
sml

Thank you so much Dr Lam for your honest opinion. How long does Perlane last? I heard a lot of horror stories about Radiesse causing lumps. Is Perlane better in that sense?

Thanks again.

radiesse won't cause lumps in the right hands especially if you stay away from around the eyes. i think it is a good product but i stopped using it in younger people because the skin underneath gets firmer and firmer over time. perlane in the buccal area tends to last well. i have seen many of my patients who get 2 or 3 rounds of it and they can hold for years. obviously, i cannot promise that to you but what i have observed.
best,
sml

Hi Dr Lam,

Thank you so much for your answers. Would you please provide me with your email address? I can't attach any of my pictures on your client request form from your site. I would really appreciate it if you could let me know if there are any solutions to help with my lower cheek from buccal fat removal. I realized there are a lot of Asian females that had fallen into the trap from irresponsible surgeons to have this surgery done. (I myself have been living in misery from the result as my surgeon lied about the outcome although I have asked) I really appreciate your honestly, I believe the number one criteria for people to search for a good filler/surgeon is "honesty". Thank you so much.

sure, thank you. drlam@lamfacialplastics.com.
best,
sml