Alexander Rivkin, MD
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Alexander Rivkin, MD
Plastic surgeon | Views: 243876

Friendname: AlexanderRivkinM.D.
Business Name: Westside Aesthetics
Website: www.westsideaesthetics.com
Location: 1033 Gayley Ave #104
los angeles, CA 90024
United States
Telephone: 310 443 5273
Languages Spoken: English

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Ask An Expert > Alexander Rivkin Message Board > what is currently the best filler for high volume areas if you are too lean to get autologous fat injections? Is it best to avoid cheek implants?
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Jensen Beach, FL
what is currently the best filler for high volume areas if you are too lean to get autologous fat injections? Is it best to avoid cheek implants?
Not able to take advantage of fat transfer. Do the fillers give a lumpy apearance on someone with thin skin? Does it encapsulate in large areas such as the cheeks?


Plastic surgeon
Miami, FL
United States
View My Professional Profile
  November 14, 2011 3:45 AM

Radeisse but gets very expensive.

Plastic surgeon
New York, NY
United States
View My Professional Profile
  November 14, 2011 12:16 PM

Radiesse and Restylane Sub Q. Believe it or not I have never seen a patient who did not have enough fat for the cheeks. Get a consultation.
Good luck from NYC

Plastic surgeon
los angeles, CA
United States
View My Professional Profile
Sculptra and Radiesse  November 15, 2011 2:35 PM

Depending on which areas you are talking about, the optimal injectable agent varies.
The most common high volume area in my practice is the front area of the cheeks, just under the lower eyelids (malar area). This is one of the first areas to lose volume as we age. Volume loss here is a big component of how old people look. I usually use Radiesse here - it is a long lasting, smooth filler that keeps its shape very well when injected deep. This is important because as I fill that area of the cheeks, I want it to have the round shape that the patient had in their youth. I do not want to use a soft filler like Juvederm because it squishes down and the final appearance is of a flat, not round cheek. If the patient is unsure of the procedure, I will offer to use Perlane, a high density hyaluronic acid filler. It doesn't last quite as long as Radiesse, but it does give that round shape and it is, most importantly, dissolvable at any time with an enzyme.
If you are talking about large surface areas like the soft part of the cheeks or the temples, I use Sculptra. This is not a filler at all, but a collagen stimulating agent. I like to think of it as a fertilizer for the skin. It pushes your skin to make more collagen and fill the area naturally. It takes 2 to 4 monthly sessions, but the results last 2 to 3 years or more.
With all of these injectable agents, it is possible to get a perfectly smooth and natural appearance without lumps. You just have to choose an injector who is very experienced at non surgical volume enhancement. Word of mouth, looking at the injectable companies' websites for people who use lots of the filler and asking the doctor and his staff direct questions are the ways to determine their experience.
Good luck!

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Cheek enhancement with Radiesse



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