I Got a Cheek Augmentation… in Front of a Live Audience

Every job has its perks. Some come in the form of traditional benefits – health insurance, a 401(k), paid time off – while others tend to be more amorphous and highly profession specific. Like cheek augmentations for beauty writers.

Because of my job, I am offered services and products around the clock. I rarely (read never) say ‘”yes!” even to free Botox or injectable fillers, as my journalism school training taught me a lot about ethics and objectivity in reporting. Plus, as we all know, nothing is really for free. There are usually hidden costs, obligations and expectations associated with pretty much everything.

This all said, I was recently attending an aesthetics conference that brought together an elite cadre of dermatologists and facial plastic surgeons to learn from one another. As part of these conferences, expert injectors are often asked to demonstrate their technique for less-experienced doctors. Over the years, many of these doctors have become my friends in addition to trusted sources, so when one such surgeon/friend asked me to be his patient during a live demonstration for injectables, I accepted.

“Wait a second,” I said, as he studied my face and cheek bones under the harsh, unforgiving lights of the Las Vegas-based conference center. “What is it that you think I need?”

“You could use some cheeks,” he answered, almost too quickly for my taste. Until that moment, I thought I had cheeks. In fact, I thought everyone had cheeks. He continued: “There is some flatness in your midface, and if I fill it in just right, we can get rid of some of that early jowling…”

Just then I pictured my maternal grandmother and my father’s clearly late-stage jowling around the recent Thanksgiving table. Not a pretty image, I assure you. “I’m in,” I said with the same gusto that anyone would have mustered given my gene pool.

Good Candidate, Crowd Pleaser

I don’t much love being in front of a crowd (thus my decision to major in print journalism, while many of my peers focused on broadcast), but I didn’t have much time to stress about my lack of cheeks, early jowling, family resemblance or impending performance. The doctor was pumped to inject the relatively new Juvederm Voluma into my midface.

Juvederm Voluma is a “designer-filler” that is literally made for sunken cheeks and midface augmentation. I had written enough about Juvederm, Restylane, fat transfer, cheek implant surgery, and various other facial plastic surgery procedures to be more than comfortable with this choice.

“C’mon”, he said, ushering me by the hand into the sterile, but lively live patient demonstration room. I filled out the requisite forms – listing all known allergies (none) and assuring the powers that be that I wouldn’t sue, and was aware that it would be a live demo.

I also had to list my current medications and go over my medical history. This section on forms always freaks me out. Just being asked “Have you ever had a seizure?” makes me think I may be having one at that moment, and sends me spiraling down a very slippery hypochondriacal slope.

This is bad enough in a waiting room, let alone in front of a group of aspiring injectors taking copious notes and analyzing my facial structure with quizzical looks.

Numb and Number

The doctor’s wife and trusted assistant was by my side. I grabbed her hand, maybe a bit too tightly as evidenced by her wincing smile (she is also drop-dead gorgeous, but I digress), as he explained that the first step is to inject local anesthetic in the treatment area. He prefers this to the two-in-one approach – many of today’s fillers come with anesthetic already mixed in, but an individual injection really does the trick.

“A numb patient is relaxed and the injector can do a better job,” he told the crowd.

I don’t know if I would use the word “relaxed” to describe my state at that moment, but I did become numb and number in the midface as he continued with the lidocaine shots. He let the anesthetic do its thing, and ever the showman, focused on the crowd, detailing his technique.

“A useful method of addressing the midface is to think of the cheek in a circular pattern where three concentric circles converge,” he said, using my face as something like a smart board. “The circles only serve as a guide to the subunits of the cheek area.“

“What if you hit a blood vessel?” a woman asked. Not something I wanted to hear asked or answered. He explained that the likelihood was extremely low, made even lower by his experience in facial aesthetics and injections. He is among the best so I knew I was in good hands.

We were ready to start. First he marked my face, and then began injecting the concentric circles that would soon become my cheeks. Much like I tell my kids during the annual shots, if you don’t look at the needle, it won’t hurt. This is especially true when you are numb to begin with.

Unfortunately, the faces in the crowd did see – and react – to the needles with widening eyes and winces. I took a deep breath, squeezed the assistant’s hand even harder, and basically tried to visualize a happier and much cheekier place.

Another question from the crowd interrupted my trance: “Do you have a protocol for hyaluronidase to reverse the effects of the filler if you had to?”

“Of course. All injectors have their own protocol, and anyone who has never used hyaluronidase simply hasn’t done enough HA-fills,” was the doctor’s astute response. “When hyaluronic acid-based fillers are used, unhappy patients have the option of reversing the effects with hyaluronidase. Reasons for dissatisfaction can include looking over-done, prolonged swelling, infection, allergic reaction, or unwanted lumps and bumps that don’t go away with massage.”

I looked toward the crowd and saw lots of nodding, yet when I scanned for a sympathetic face to level with me as he continued the injections, there were none in sight.

He asked me to smile before finally putting some finishing touches on both sides.

“Wow,” a woman said, looking at me. The doctor smiled at both of us.

I took a deep breath, squeezed the assistant’s hand even harder, and basically tried to visualize a happier and much cheekier place.

Sweet Cheeks

He showed me a handheld mirror, and I have to say, I was impressed. The effect of Voluma happens instantly, and while it doesn’t offer a permanent solution, it can last up to 18 months. I had no pain and I had cheeks. Yes, there were tiny red pinpricks like connect the dots on my face, but I knew enough to know that this roadmap is temporary. I promised to massage the area and use ice, follow a laundry list of other post-treatment instructions to speed up recovery time, and was sent on my way.

The next morning I woke looking like Rocky Balboa after he’d lost. My lower eyelids and tear troughs were so swollen I could actually see them. Good thing, I packed sunglasses. In Vegas, no one looks twice if you are wearing sunglasses by day. They assume you had a rough night on the town. I had anything but. My night consisted of ice packs, room service and a particularly enthralling Law and Order SVU marathon.

Back at the convention the next morning, my colleagues and other attendees thought I looked pretty good considering. The doctor couldn’t believe how lucky I was not to bruise. Voluma side effects may include redness, swelling, or bruising after treatment.

I continued with the ice, and took some Tylenol, just in case, but for the most part, I was feeling fine within 24 hours. I still can’t unsee the jowling but perhaps that tweak will be next up on my fix-it list.

Would I recommend this treatment to someone like me who happens to be not so cheeky? Yes I would, as long as you have realistic expectations and choose a surgeon you trust who has experience.

Would I ever raise my hand again to act as a patient? Maybe. Just maybe.

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