Submalar Filler: Different Techniques and Approaches

Medically Reviewed
Medically Reviewed by Dr. Aurora Kalmanson on
Written by Fillers Editorial Team, plastic surgery specialists.

Submalar fillers are a cosmetic treatment aimed at rejuvenating the submalar region of the face, which can become hollow and aged due to loss of volume beneath the cheekbones. By targeting the buccal fat pad with precise injection techniques, submalar fillers restore volume, creating a more youthful and sculpted appearance.

This article delves into the various techniques used for submalar filler application, including deep and superficial cannula methods, as well as needle techniques, and discusses their benefits, specific injection points, and the aesthetic outcomes they can achieve.

Submalar Filler Techniques and Approaches

Submalar filler techniques are diverse, each adapted to address the unique contours of the face. The choice of technique is critical for achieving a natural and harmonious enhancement of the submalar region.

Cannula Technique in the Deep Plane

Targeting the Deep Buccal Fat Pad: The deep buccal fat pad is a key area for volume restoration in the submalar region. The cannula technique in the deep plane involves injecting filler below the superficial muscular aponeurotic system (SMAS), directly into the deep buccal fat pad. This method is particularly effective for patients with significant facial hollowing due to aging, weight loss, or other factors. By replenishing the deep fat pad, the face regains its youthful fullness, and the inverted triangle of aging is softened, leading to a more refreshed and vibrant appearance.

Advantages and Specific Injection Points: The deep plane cannula technique offers several advantages, including minimized risk of bruising and less discomfort due to the blunt tip of the cannula. Specific injection points are chosen to strategically augment the deep buccal fat pad, providing support and volume where it is most needed. This approach not only enhances the submalar area but also contributes to a lifting effect that can reduce the prominence of nasolabial folds. The precision of this technique allows for an adapted treatment plan that aligns with the patient’s facial structure and aesthetic goals.

Cannula Technique in the Superficial Plane

Enhancing the Superficial Buccal Fat Pad: For a more subtle enhancement, the cannula technique in the superficial plane targets the superficial buccal fat pad, which lies above the SMAS and below the skin. This technique is ideal for patients seeking to address mild to moderate facial hollowing and for those who wish to achieve a gentle contouring of the cheeks without the intensity of deep plane injections. By adding volume to the superficial fat pad, the skin gains a smoother, more supple appearance, and the overall facial shape becomes more rounded and youthful.

Aesthetic Outcomes and Procedure Overview: The aesthetic outcomes of submalar filler procedures are transformative, offering a rejuvenated and more youthful facial contour. The procedure is typically quick, with immediate results and minimal downtime. Patients can expect a noticeable restoration of volume in the submalar region, leading to a softening of the hollows beneath the cheekbones. The overall effect is a subtle lift that enhances the natural structure of the face without appearing overdone. The procedure overview includes an initial consultation to discuss goals and expectations, followed by the selection of the appropriate filler material and injection technique. Post-procedure, patients are advised on aftercare to ensure optimal healing and longevity of the results.

Needle Technique in the Superficial Plane

Linear Antegrade and Retrograde Injection Methods: The needle technique in the superficial plane can be performed using linear antegrade or retrograde injection methods. These methods involve the precise placement of filler using a needle, which allows for a controlled distribution of the product along a linear path. The antegrade method involves injecting the filler as the needle advances, while the retrograde method deposits the filler as the needle is withdrawn. Both techniques require skill and precision to ensure even distribution and to avoid overcorrection. The choice between antegrade and retrograde methods depends on the specific area being treated and the desired outcome.

Comparing Needle and Cannula Approaches: Comparing needle and cannula approaches reveals distinct advantages and considerations for each. Needles allow for a more precise injection and are often preferred for fine-tuning and detail work. Cannulas, with their blunt tips, are less likely to cause bruising and can cover a larger area with fewer entry points. The choice between the two often comes down to the practitioner’s expertise and the patient’s comfort level, as well as the specific area of the face being treated. Both methods can achieve excellent results when performed by an experienced injector.

Combining Submalar Fillers with Other Facial Procedures

Integrating submalar fillers with other facial rejuvenation techniques can amplify the benefits, leading to a more comprehensive aesthetic enhancement.

Synergistic Effects with Facelift Surgery

Volume Restoration and Tissue Redistribution: When combined with facelift surgery, submalar fillers contribute to volume restoration and tissue redistribution, enhancing the overall result. The fillers can be used to fine-tune the contours of the face post-surgery, smoothing out any irregularities and providing a seamless finish. This synergistic approach allows for a customized redistribution of facial volume, addressing the multi-dimensional aspects of facial aging. The strategic placement of fillers can also influence the direction of tissue lift during surgery, resulting in a more natural and youthful facial contour.

Submalar Implants as a Permanent Solution

Comparison with Fat and Fillers: Submalar implants offer a permanent solution to volume loss in the cheek area, contrasting with the temporary effects of fat transfer and dermal fillers. While fat grafting provides natural-feeling results, its longevity can be unpredictable due to the variable survival rate of the transferred fat cells. Dermal fillers, though temporary, allow for adjustments over time and have minimal downtime. Implants, on the other hand, require a surgical procedure with a longer recovery period but offer a lasting solution. The choice between these options depends on the patient’s preferences for maintenance, permanence, and their individual anatomical considerations.

Frequently Asked Questions

How long do submalar filler results typically last?

Submalar filler results can last anywhere from 6 months to 2 years, depending on the type of filler used and the individual's metabolism and lifestyle.

Can submalar fillers be combined with other facial rejuvenation procedures?

Yes, submalar fillers can be effectively combined with other procedures such as Botox, laser treatments, or facelifts for a more comprehensive facial rejuvenation.

Are there any risks associated with submalar fillers?

While generally safe, risks can include bruising, swelling, asymmetry, and less commonly, infection or filler migration. It's important to have the procedure done by a qualified professional.

How does submalar filler treatment differ from cheek implants?

Submalar filler treatment is non-surgical and temporary, offering a way to test desired results before committing to the more permanent, surgical option of cheek implants.

Can submalar fillers be reversed or adjusted after treatment?

Yes, certain types of submalar fillers made from hyaluronic acid can be dissolved and adjusted post-treatment with an enzyme called hyaluronidase.


Submalar fillers offer a versatile and minimally invasive option for those looking to restore facial volume and achieve a more youthful appearance. With various techniques and materials available, they can be tailored to meet individual aesthetic goals and can be combined with other procedures for enhanced results. While there are some risks, the procedure is generally safe when performed by a skilled practitioner. The temporary nature of fillers also provides flexibility for adjustments as needed, making them a popular choice for facial rejuvenation.

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Delaney, S., & Kridel, R. W. H. (2019). Enhancing Facelift With Simultaneous Submalar Implant Augmentation.

Lipko-Godlewska, S., Bolanča, Ž., Kalinová, L., Kermen, I., Onisak, B., Papp, I., Rebrov, M., & Valančienė, G. (2021). Whole-Face Approach with Hyaluronic Acid Fillers.

Dr. Aurora Kalmanson

Always Consult a Medical Specialist

The information provided in this blog is for informational and educational purposes only and should not be interpreted as personalized medical advice. It's crucial to understand that while we are medical professionals, the insights and advice we provide are based on general research and studies. They are not tailored to individual health needs or conditions. Thus, it is essential to consult directly with a healthcare provider who can offer personalized medical advice relevant to your specific situation.