Can Fillers Create a Lifting Effect?

A Closer Look at Lifting Fillers, Volume Fillers, and the Line of Ligaments Theory — with a Focus on Lateral Cheek Fillers

Photo by Kamila Maciejewska on Unsplash

Hello, I’m Dr. Jeonghyeon Kim, Medical Director.

Today, I’d like to discuss one of the most commonly performed aesthetic procedures — yet one that continues to generate misunderstanding and debate: Filler Injection.

In particular, this column centers on a question I am frequently asked in clinical practice: Can fillers actually produce a lifting effect?

What Is a Filler?

The term filler quite literally means “to fill.” Clinically, it refers to the injection of skin-compatible materials into areas where volume has been lost or structural support is needed, with the goal of improving contour and facial balance.

Fillers are typically injected into the dermal layer or the subcutaneous fat layer using a syringe. Through this approach, depressed areas can be restored and wrinkles softened.

Compared with surgical methods that rely on solid implants or artificial inserts, filler procedures are relatively quick, involve minimal scarring, and require shorter recovery times. For this reason, fillers are often chosen by individuals who prefer non-surgical aesthetic options.

Can Fillers Provide a Lifting Effect?

In recent years, the number of patients seeking filler treatments has increased noticeably. Among these, inquiries about lateral cheek fillers have grown particularly steadily.

As interest in dieting and body slimming continues to rise, many individuals experience unintended volume loss in the face during weight reduction. One of the most affected areas is the lateral cheek.

Loss of volume in this region can make the face appear gaunt or older than its actual age. As a result, many patients who are actively managing their weight identify the lateral cheek as a primary area of concern — naturally leading to increased demand for lateral cheek fillers.

In this column, rather than broadly addressing all filler techniques, I will focus specifically on lateral cheek fillers, examining them from a more structural and anatomical perspective.

What Exactly Is the Lateral Cheek?

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The lateral cheek generally refers to the outer cheek area located between the zygomatic bone and the mandible, extending from the ear forward beneath the cheekbone.

Because the volume and contour of this region play a critical role in defining overall facial shape, it is considered a key area in aesthetic assessment.

In East Asian faces, which often have relatively flatter facial planes, softer and smoother contours are typically preferred over sharply protruding zygomatic prominence. For this reason, treatment strategies often aim to achieve facial slimming while preventing excessive volume loss in the lateral cheek — where filler intervention may be considered.

Key Considerations When Performing Lateral Cheek Fillers

Filler injection is not simply a matter of adding volume where it appears deficient. Achieving natural results requires a comprehensive evaluation of facial anatomy, skeletal structure, individual variation, and skin quality.

Because the lateral cheek significantly influences overall facial balance, it is often addressed earlier than other regions or recommended in combination with lifting procedures.

At this point, it becomes essential to introduce a core anatomical concept frequently referenced in both research and clinical practice.

Line of Ligaments Theory

One of the most important concepts in facial anatomy is the Line of ligaments theory.

This theory describes an imaginary line connecting four major facial ligaments:

• Temporal ligamentous adhesion
• lateral orbital thickening
• zygomatic ligament
• mandibular ligament

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This line begins at the temporal region, passes along the zygomatic arch, and extends down to the mandibular border. Functionally, it divides the face into medial and lateral zones.

According to this theory:

• Filler injections medial to the ligament line primarily contribute to volume augmentation.
• Filler injections lateral to the ligament line can create a lifting effect by pulling facial structures upward and posteriorly.

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Clinical observations support this concept. When fillers are injected into the Superficial lateral temporal cheek fat compartment, changes such as enhanced mandibular angle definition and softening of the marionette line have been reported.

These findings suggest that fillers do more than simply restore depressed areas. When injection planes and spaces are selected based on anatomical principles, fillers can contribute to overall contour improvement.

Conversely, when volume is added without considering these structural relationships, facial harmony may be disrupted, and the face may even appear heavier or more sagged.

Fillers and Lifting: A False Dichotomy

What truly matters is moving beyond the simplistic distinction that “fillers add volume, while lifting procedures pull tissue upward.”

Depending on an individual’s anatomy, aging pattern, and primary aesthetic goals, the same filler procedure can yield very different outcomes.

Rather than focusing solely on isolated volume deficits, a personalized treatment plan that considers overall facial structure and balance is essential.

Today’s Beauty Insight

“When planning lifting procedures, lateral cheek fillers may be recommended concurrently in certain cases.”

In this column, we explored the relationship between fillers — particularly lateral cheek fillers — and lifting effects from an anatomical perspective.

In the next article, I will discuss nasolabial folds, true retaining ligaments, and cheek fillers in greater depth.

Thank you for reading.

Dr. Jeonghyeon Kim.