Filler cheeks: a bright idea? The "eyes" have it.

The evolving field of facial volume restoration is changing our concept of facial rejuvenation. The older concept that "tighter is better" has been largely supplanted by a philosophy recognizing the importance of volume distribution as a defining characteristic of a more youthful face. It is well recognized that restoration of volume in the upper face can lessen or reverse the bottom-heavy, deflated appearance of the aging face. Perhaps of equal or greater importance is the change in light-reflectance patterns that illuminate the upper cheeks and the eyes. The resultant brighter and "perkier" cheeks can change the objective appearance and the patient's self perception of youthfulness. In this commentary, the author describes techniques to enhance outcomes and patient satisfaction and presents the results of a patient self-report pilot study assessing patient post-injection mood state and functioning.