If you've noticed that your cheeks and smile lines around the mouth have started drooping, there's a filler for that.

Injectable fillers aren't new to the skin-restoration scene; they've always been a super-effective way to fatten up thin lips, improve the look of scars, under-eye circles and crows feet, add volume to saggy earlobes and, in particular, plump up cheeks and fill in laugh lines.

"Cheeks sag as we age due to a loss of supporting tissues including collagen, fat and bone," says Dr. William Middleton, B.Sc., MD, FRCSC, a cosmetic surgeon in Toronto. And once our cheeks start descending, the rest of our face follows suit. Eventually the fat pads in our face start diminishing, and that downward push from saggy cheeks leads to "deeper and deeper nasolabial folds (smile lines) over time, if there isn't appropriate intervention," warns Oakville, Ont.-based cosmetic dermatologist Dr. Sheetal Sapra, MD, FRCPC. "While you may have thought that your smile lines were cute in your thirties, they are much more likely to bother you in your fifties and sixties because they give us a negative and tired-looking expression, which can make us look older than we really are."

The good news is there are many non-invasive ways to slow the face-aging process and plump up the apples of your cheeks before they sink. Here's how:


There are a handful of ways to keep your skin supple, your cheeks plump, your laugh lines minimal — the most important of which is leading a healthy lifestyle. "Smoke, stress, excess alcohol and excess sun exposure create free radicals that speeds up tissue breakdown, which contributes to premature aging," Dr. Middleton says. Getting enough sleep, maintaining a proper skin-care regime, taking vitamins and even getting Botox injections have all been shown to slow the aging process and keep your skin looking younger for longer.

The single most important factor in keeping your youthful glow is to slather on that sunscreen (every day, people!) and use one that's at least SPF 30 to protect your skin from harmful ultraviolet rays. If you spent your teen years sunbathing and baking in baby oil, the damage can be partially reversed. "It's important to know that it is never too late to start; it's better late than never to start using sunscreen," Dr. Sapra says.


Injectable fillers have been around for years. In the past they were used as a corrective agent to fix the lines and deflated areas that already existed. Collagen was the filler of choice in the '80s but had too short a lifespan and injections would only last weeks at a time.

Newer fillers on the market last longer, some have a numbing agent (xylocaine) that lessens the discomfort experienced during the injection procedure, and many can actually prevent the lines that the old injections only fixed. Hyaluronic acid (Restylane, Juvederm, Ovita, Volumna and Perlane contain it) is a "natural component of our skin, and the effect of these fillers wears away naturally and gradually," says Edmonton-based cosmetic dermatologist Dr. Marlene Dytoc, MD, PhD, FRCPC.

While the results are still only temporary, many products generally last about six months. Radiesse, a calcium-based filler, can last more than a year and is a favourite among doctors who use it to build up cheek and nasal contouring. Artesense can fix acne scars and deep laugh lines, while Sculptra, used in the temples and cheeks, provides volume and enhances the quality of the skin by increasing collagen, says Dr. Sapra. Other therapies, including the much-talked-about Selphyl, also known as the Vampire Facelift (see Blood Lines on page 20) and new ultrasound-based skin-tightening procedures using Ulthera, can tighten the skin's collagen and help fill lines and tighten the jowls and neck.

Cost varies depending on which filler the doctor chooses to suit your needs and the number of injections required, but the average price is about $500 to $750 per injection. Side-effects are minimal and mild (redness, swelling, slight bruising, tenderness). Like many other procedures and medications, Dr. Dytoc says pregnant and nursing women should delay getting fillers.