Cheek filler is the placement of structural hyaluronic acid filler on the cheekbone. The cheekbone — to restore volume the midface has lost, to build definition it never had, or both. The two goals need different placement: restoration puts volume back into the front cheek where the fat pad has deflated. Definition adds projection higher and further out along the outer cheekbone because the cheek is the scaffold that holds the midface up, restoring it lifts everything above and below it. Softening the nose-to-mouth lines, lifting the floor of the tear trough and reducing the drag that starts a jowl. Often without treating those areas directly. Typically 1–2ml is used across both cheeks. Results are immediate, settle at two weeks, last 12–18 months and are fully reversible. At Medisha Clinic every cheek treatment is performed by Dr Nish Shah MD using The Medisha Method.

At Medisha Clinic in Mayfair, cheek filler is £350 for 1ml across both cheeks and £600 for 2ml, using structural reversible HA, with a complimentary 4-week review and any refinement included. Consultation with Dr Nish is £50, fully redeemable against treatment, so if you go ahead it costs nothing. Cheek and tear trough together start from £800, and cheek with chin and jaw as a full structural programme is quoted at consultation. The clinic is at 58 South Molton Street, Mayfair, London W1K 5SL, three minutes from Bond Street station.

Fewer than most clinics will sell you. With structural HA placed correctly on bone, 1ml across both cheeks produces a clear, natural restoration or definition for most patients; 2ml is used where volume loss is more marked, where both restoration and definition are wanted, or for a sculpted masculinisation or feminisation result. Beyond 2ml in a single session is rarely appropriate and is usually a sign of soft filler being used to compensate for poor placement. The lift comes from where the product sits on bone, not from how much is used. Dr Nish maps your face at consultation, recommends a volume, and will not sell you more. At Medisha the review at four weeks exists so that anything further is added later rather than over-corrected on the day.

Not when it is done correctly, and pillow face is precisely the result The Medisha Method is built to avoid. The over-filled, shelf-like or puffy cheek comes from three errors: soft, water-binding filler that belongs in lips being used in the cheek. Placement in the fat rather than on the bone, so the product spreads and swells, and volume being added to a face that needed lifting rather than filling. At Medisha, only firm structural HA is used in the cheek, it is placed as small checked deposits directly on bone, the face is reassessed from three angles and in movement after every deposit. Patients whose real problem is descent are sent for threads rather than filler. The end point is a face that looks rested, not one that looks done, and if you have been over-filled elsewhere it can be dissolved and re-treated.

Usually yes, and usually better than filling the fold itself. A deep nose-to-mouth fold is most often the result of a dropped, deflated cheek: as the cheek fat pads? empties and slides down, the skin bunches at the fold below it. Injecting the fold directly plumps the crease but does nothing about why it is there, and repeated fold filler produces the heavy, stiff upper lip seen on many London faces. Restoring the cheek lifts the fold from above. The correction is more natural, lasts longer and improves the whole midface. Dr Nish assesses this at consultation. In most patients the cheek is treated first and the fold only if anything remains. The same logic applies to the tear trough, which a restored cheek often corrects without any under-eye injection.

Typically 12–18 months, at the longer end for structural HA placed on bone, because the cheekbone barely moves and the product is not being worked by muscle the way lip or fold filler is. Longevity varies with the product, your metabolism and lifestyle factors such as intense exercise and sun exposure. A second treatment often lasts longer than the first because some structural scaffold persists. When the effect fades a smaller top-up restores it because Dr Nish uses only reversible HA, the filler can also be dissolved at any point.

Most patients describe pressure rather than pain. Topical anaesthetic is applied for 15–20 minutes and the structural filler contains lidocaine. The deep, on-bone placement is in a plane with few nerve endings. Downtime is short: the result is visible immediately, most patients return to work the next day, mild swelling and tenderness over the cheekbone settle within 3–5 days. The area may feel firm to the touch for a few weeks as the filler integrates. Bruising, if any, clears within a week. The result is considered final at two weeks. For two weeks avoid facial massage, facials, sleeping face-down and, if it can wait, dental work. For 48 hours avoid vigorous exercise, alcohol and heat.

Yes. The cheek is one of the most powerful levers for both, and the placement is different for each. For feminisation, volume goes higher and more front, creating a soft, rounded, lifted cheek prominence that catches light along a curved line. For masculinisation, projection goes more outer along the outer cheekbone with a flatter, more angular contour and a defined hollow beneath. Dr Nish maps the face from three angles and designs the placement for the result you want, frequently as part of a fuller programme with the chin and jaw. The same structural, on-bone, minimum-volume principles apply: the shape comes from placement, not from quantity.

They correct different problems. Cheek filler replaces volume: it is the treatment for a cheek that has emptied and flattened. A PDO thread lift repositions tissue: it is the treatment for a cheek that has slid downward, taking the fold and the jowl with it. Filler into a face that needs lifting adds bulk in the wrong place and is a common route to pillow face. Threads into a face that needs volume lift skin over an empty scaffold and look tight rather than young. Most faces over 40 have some of both, and the usual Medisha sequence is filler first to rebuild the scaffold, then threads if descent remains. Dr Nish performs both. He is Brand Ambassador and KOL for dermal fillers and one of the UK’s most experienced thread practitioners, and will tell you which you need.

Yes, and it is the natural starting point for most facial programmes. Cheek with tear trough treats the midface and the under-eye in one session, and the cheek is always assessed first because it may correct the trough on its own. Cheek with chin and jaw is the full structural harmonisation programme, and the basis of masculinisation and feminisation. Cheek filler followed by PDO threads addresses volume loss and descent in sequence. Cheek filler with Profhilo or Sunekos restores the scaffold and then the quality of the skin over it. Filler and threads are usually spaced 2–4 weeks apart; Dr Nish designs the sequence at consultation.

In specialist hands the cheek is one of the safer filler areas, because the placement plane is deep on bone and away from the main vessels. But that safety depends on the injector knowing exactly where the facial artery and under-eye vessels run. Expected, temporary effects: swelling and tenderness for 3–5 days, firmness for a few weeks, bruising for up to a week. Uncommon risks: asymmetry (assessed and adjusted at the 4-week review). Over-filling or a visible shelf (avoided by structural product, on-bone placement and conservative volume). Migration (a soft-product problem, avoided by using structural HA). Infection (rare, sterile technique), and a blocked blood vessel — rare in the cheek, minimised by checking for blood vessels, small deposits, reversible HA and hyaluronidase on site. Warning signs are skin blanching or mottling or disproportionate pain, and Dr Nish provides his direct number for the first 48 hours.

Because the cheek rewards judgement and punishes quantity, and Dr Nish supplies the first and refuses the second. He is a medically trained doctor, a specialist in structural facial filler, Brand Ambassador and Key Opinion Leader for dermal fillers with a global manufacturer, Senior International Clinical Trainer at Derma Medical where he teaches this procedure to other doctors, and has performed over 30,000 non-surgical treatments. One of the most experienced aesthetic doctors in the UK — using the same deep-plane, checked, reversible protocol he teaches. Every cheek treatment is his, using The Medisha Method: mapping your face from three angles to decide whether it needs restoring or defining and whether the cheek is the real cause of your folds or trough. Structural HA placed deep on bone in small checked deposits. Live recontouring in movement, and a 4-week review with refinement included. 1ml £350, 2ml £600; £50 consultation redeemable. 58 South Molton Street, Mayfair, London W1K 5SL, three minutes from Bond Street. Also Marylebone.