Legal disclaimer

This guide provides general information about cosmetic cheek injections for adults aged eighteen years and over and does not replace individual medical advice, diagnosis, or treatment.^{1 9}

Any decision to have cheek filler should follow a proper consultation with a suitably qualified health practitioner, including discussion of risks, benefits, alternatives, and the option not to proceed.^{2 9}

Products used for cheek injections are usually prescription-only medicines. Their use and how they can be advertised are regulated under the Health Practitioner Regulation National Law and Commonwealth therapeutic goods legislation.^{1 3}

This document is written to align with AHPRA advertising guidelines and TGA guidance on advertising health services, by avoiding medicine names, promotional claims, discounts, or guaranteed outcomes.^{1 3}

1. Scope of this guide

This guide covers cosmetic use of hyaluronic-acid-based injectable gels to the cheek and mid-face region in adults, focusing on mechanism, appearance changes, governance, risks, and typical recovery.^{2 7}

It does not cover reconstructive or therapeutic indications, permanent or non-hyaluronic fillers, adolescent procedures, or treatment during pregnancy or breastfeeding.^{2 9}

The content is intended as neutral patient education about a regulated health service, not as promotion of a specific clinic, practitioner, or product, consistent with AHPRA and TGA expectations.^{1 3}

2. What is cheek filler?

2.1 Plain-language description

Cheek filler is a cosmetic injectable procedure where a registered health practitioner places controlled amounts of hyaluronic acid gel into selected areas of the mid-face to restore or enhance cheek volume, contour, and support.^{2 9}

Hyaluronic acid is a sugar molecule that occurs naturally in the body and helps hold water. In regulated injectable form it can be used to improve the appearance of flattened or volume-depleted cheeks by adding structure underneath the skin.^{3 7}

In clinically led practice, the goal is usually to give a fresher, more balanced look rather than an obvious or extreme change.^{2 9}

2.2 Regulatory context in Australia

Injectables used in cheeks are typically Schedule 4 prescription-only medicines. Health professionals and cosmetic clinics are not permitted to advertise these medicines to the public, even indirectly, as products.^{3 4}

The TGA’s guidance on advertising health services and cosmetic injections explains that clinics may describe the service and process but must not name or promote specific prescription-only products or use indirect code-words to do so.^{3 4}

AHPRA’s cosmetic procedure guidance also sets expectations for consultation, patient assessment, consent, and cooling-off periods for higher-risk non-surgical cosmetic procedures.^{2 8}

Clinical pearl

If a clinic presents cheek injections as quick, casual, or “no risk”, that is out of step with how regulators describe cosmetic procedures in Australia.^{1 3 9}

3. How does hyaluronic acid filler work in the cheeks?

3.1 Volume support and contour

In cheek filler treatments, hyaluronic acid gel is usually placed on or near bony surfaces and deep fat pads of the mid-face. This helps replace some of the volume and structural support that can reduce with age or weight change.^{2 7}

When support is restored in these areas, the mid-face can look less sunken, light can reflect more evenly across the cheek, and the junction between the lower eyelid and cheek may appear softer.^{2 9}

The practitioner chooses the firmness of the gel, the depth, and the placement pattern based on the person’s bone structure, soft-tissue thickness, and facial proportions.^{2 8}

3.2 Facial anatomy and technique

Ageing in the mid-face involves changes to bone, deep and superficial fat, ligaments, and skin, which together affect how volume loss and sagging show on the surface.⁷

The cheek area includes important blood vessels and nerves, so practitioners are expected to have specific anatomical training, understand higher-risk zones, and adjust technique to reduce the risk of vascular or nerve injury.^{2 7}

Current cosmetic procedure guidance makes it clear that higher-risk non-surgical procedures like facial injectables should only be performed by suitably trained and registered practitioners with appropriate supervision and escalation pathways.^{2 9}

Clinical pearl

A small amount of product placed in the right structural area often does more for the face than a large amount spread into every fold and line.

4. What results should patients expect?

4.1 Visual changes

Many patients notice that their mid-face looks less hollow or tired and that the cheeks reflect light more evenly, which can give a “well-rested” appearance.^{2 9}

Improving cheek support can soften the appearance of some under-eye hollows, though it does not correct skin laxity, pigmentation or all fine lines.^{7 9}

From the front, the face may look more balanced, and from the side, cheek projection can sit more in proportion with the nose, lips, and chin, depending on the starting anatomy and volume used.^{2 9}

4.2 Time course of chang

Swelling is common after cheek injections and often makes the cheeks appear slightly fuller or higher for the first few days.^{6 7}

Swelling usually peaks in the first two to three days and settles gradually; most people see a more realistic result after one to two weeks.⁷

The gel and surrounding tissues continue to settle over several weeks, so final contour and symmetry are best reassessed at around four weeks in a review appointment.⁷

4.3 Balance with the rest of the face

Australian professional guidance encourages a whole-of-face approach when planning cosmetic procedures, rather than focusing on a single feature.^{2 9}

Counselling should make it clear that filler can improve the appearance of volume loss and contour but will not stop ageing or replace surgical procedures when those are more appropriate.^{2 9}

Clinical pearl

As a simple rule, if people say “you look well” rather than “what have you done to your cheeks”, the treatment is usually closer to the right balance.

5. How long does cheek filler last?

5.1 Typical duration

Cheek filler is temporary. Hyaluronic acid is gradually broken down and cleared by the body.^{3 7}

In practice, many people notice a useful cheek effect for around twelve to eighteen months, though this varies from one person to another and between products.^{2 9}

5.2 Factors influencing longevity

The duration of effect can be influenced by product properties, depth and pattern of injection, metabolism, age, skin quality, significant weight change, smoking, and very intensive exercise.^{2 7}

Cheek filler typically lasts longer than lip filler because cheeks move less, but it still reduces gradually over time rather than “dropping out” suddenly.^{3 7}

5.3 What happens when it wears off?

As the filler degrades, the extra volume reduces and the face moves back towards its earlier contour over months.^{3 7}

RACGP submissions and cosmetic practice reviews focus on governance and training rather than suggesting that correctly performed cheek filler accelerates sagging; the underlying ageing process continues regardless of treatment.⁹

Clinical pearl

Top-ups can be spaced out and based on visible changes. A conservative, gradual approach is more consistent with current Australian regulatory and professional expectations than aggressive re-filling.

6. Is cheek filler painful?

6.1 Sensation during treatment

Some discomfort is expected because injections pass through skin and deeper tissues, but most adults tolerate cheek injections reasonably well.⁷

The sensation is often described as pressure or a dull ache over the cheekbone rather than sharp, ongoing pain.⁷

6.2 Comfort strategies

Clinics commonly use topical anaesthetic creams, cool packs, distraction techniques and gels containing local anaesthetic to help reduce discomfort.^{3 4}

Additional local anaesthetic techniques may be used if clinically appropriate and within the provider’s scope and clinic protocols.²

6.3 Tenderness after treatment

It is normal to experience some tenderness or a bruised feeling when touching, smiling, or chewing for a few days after treatment.^{6 7}

Simple measures such as cool packs, sleeping with the head slightly elevated, and appropriate analgesia (where recommended) often help with early symptoms.⁷

Clinical pearl

New or increasing pain, especially with skin turning pale, blotchy, or dusky, is not typical and should be checked urgently.

7. What are the risks and side effects of cheek filler?

7.1 Expected short-term effects

Short-term effects include swelling, redness, tenderness, and occasional bruising at or near injection sites.^{6 7}

The cheeks can feel firm or uneven in the early phase while swelling settles and the gel integrates with the surrounding tissues.⁷

7.2 Less common issues

Less common problems include prolonged swelling, visible asymmetry that does not improve after swelling has gone, or localised nodules that may require review.^{2 7}

Depending on assessment, options may include watchful waiting, guided massage, minor adjustments, or in some cases dissolving a carefully selected area.^{3 7}

7.3 Serious but rare complications

Serious but rare complications include vascular compromise, where filler blocks or compresses a blood vessel and reduces blood flow to the skin.^{3 7}

Australian guidelines expect clinics providing cosmetic injections to have clear protocols and training for identifying and responding to complications, including knowing when and how to escalate care.^{2 7}

NSW Health classifies these procedures within skin penetration activities and requires compliance with infection-control and hygiene standards under the Public Health Act 2010 and Public Health Regulation 2022.^{5 6}

Clinical pearl

A reasonable question to ask any clinic is: “If there is a complication, what is your process?” — a clear, confident answer backed by written procedures is reassuring.

8. Who is a suitable candidate for cheek filler?

8.1 Potentially suitable adults

Cheek filler may be considered for adults who feel their mid-face looks tired, sunken, or flat and who are seeking modest, temporary improvement in volume and contour.^{2 9}

Younger adults with naturally low cheek projection may also be considered, with careful planning to keep results proportional and age-appropriate.^{2 9}

8.2 When treatment may be delayed or avoided

Cosmetic procedures are usually avoided in pregnancy and breastfeeding because of limited safety data and the precautionary approach expressed in professional and regulatory documents.^{3 9}

Treatment is typically postponed where there is an active infection, poorly controlled medical conditions, or recent major surgery in or near the treatment area.^{5 7}

8.3 Psychological and ethical considerations

AHPRA and the Medical Board emphasise screening for unrealistic expectations, body image concerns, and external pressure as part of cosmetic procedure assessments.^{2 10}

RACGP material similarly highlights that practitioners should be willing to decline or delay cosmetic procedures when they believe the requested changes are not in the patient’s best interests.⁹

Clinical pearl

People who want to “look like themselves on a good day” tend to adapt better than those hoping to look like a completely different person.

9. What is recovery like and what aftercare is recommended?

9.1 Early recovery (first 72 hours)

Most people can return to light daily activities soon after treatment, but visible swelling and occasional bruising are common in the first two to three days.^{6 7}

The cheeks may feel heavy or tight, and minor asymmetries often reflect swelling rather than the final appearance.⁷

9.2 First 2–4 weeks

Over the next one to two weeks, swelling usually improves and the tissues adjust around the filler, so the cheeks begin to look and feel more settled.^{7 8}

By around four weeks, healing and integration are generally far enough along for a meaningful review of contour, symmetry, and whether further adjustments are indicated.⁷

9.3 Typical aftercare advice

Aftercare instructions commonly include avoiding strenuous exercise, saunas, hot yoga, and significant alcohol intake for at least 24 hours after treatment.³

Patients are often advised not to have strong facial massage, facials, or to sleep face-down during the early healing period to limit unnecessary pressure on the treated areas.⁵

Clinical pearl

Booking cheek filler at least two weeks before important events gives a safer buffer for bruising, swelling, and any follow-up appointment.

10. Common myths and misconceptions about cheek filler

“Cheek filler always makes faces look puffy”

A puffy or “over-filled” look usually comes from excessive volume or poor planning, not from the concept of cheek filler itself.^{2 9}

“Cheek filler replaces a facelift”

Cheek filler restores volume and contour but cannot remove excess skin or provide the same degree of lifting as surgery.^{2 4}

“Cheek filler causes extra sagging when it wears off”

As hyaluronic acid breaks down, the extra volume reduces gradually. Governance and expert commentary around cosmetic practice focus on practitioner training and consent rather than suggesting that compliant cheek filler directly causes extra sagging.⁹

“More filler always gives a better lift”

In many cases, simply adding more volume widens or weighs down the mid-face instead of improving lift; current expert advice leans toward conservative, targeted placement.^{2 9}

Clinical pearl

From a risk and governance perspective, modest and reversible changes with clear documentation are more consistent with Australian standards than extreme transformation.

Sources

1. Ahpra (2024), Guidelines for advertising a regulated health service (Advertising hub — guidance document), Australian Health Practitioner Regulation Agency, viewed 2025, https://www.ahpra.gov.au/Resources/Advertising-hub/Advertising-guidelines-and-other-guidance/Advertising-guidelines.aspx. ↩
2. Ahpra (2023–2025), Cosmetic procedure guidelines and Advertising higher-risk non-surgical cosmetic procedures (Cosmetic surgery hub), Australian Health Practitioner Regulation Agency, viewed 2025, https://www.ahpra.gov.au/Resources/Cosmetic-surgery-hub. ↩
3. Therapeutic Goods Administration (2024–2025), Advertising health services and cosmetic injections: FAQs and Advertising a health service (specialised advertising issues and topics), Australian Government Department of Health and Aged Care, viewed 2025, https://www.tga.gov.au/.../advertising-health-services-and-cosmetic-injections-frequently-asked-questions-and-answers. ↩
4. Therapeutic Goods Administration (2024), Referring to cosmetic injectables in advertising, media release and guidance, Australian Government Department of Health and Aged Care, viewed 2025, https://www.tga.gov.au/news/media-releases/referring-cosmetic-injectables-advertising. ↩
5. NSW Health (2025), Beauty, body art and skin penetration industries (Public Health Act 2010 & Public Health Regulation 2022 fact sheet), NSW Government, viewed 2025, https://www.health.nsw.gov.au/environment/factsheets/Pages/beauty-treatment.aspx. ↩
6. NSW Health (2025), Skin penetration resources (hygiene, infection control & business design), NSW Government, viewed 2025, https://www.health.nsw.gov.au/environment/skinpenetration/Pages/default.aspx. ↩
7. Australian Commission on Safety and Quality in Health Care (2021), National Safety and Quality Health Service (NSQHS) Standards, second edition, ACSQHC, Sydney, viewed 2025, https://www.safetyandquality.gov.au/standards/nsqhs-standards. ↩
8. Australian Commission on Safety and Quality in Health Care (2017–2023), NSQHS Standards overview and consumer factsheets (Partnering with Consumers Standard), ACSQHC, Sydney, viewed 2025, https://www.safetyandquality.gov.au/standards/nsqhs-standards/partnering-consumers-standard. ↩
9. RACGP (2015–2022), Submission: Regulation of medical practitioners who provide cosmetic medical and surgical procedures and related regulatory materials, Royal Australian College of General Practitioners, viewed 2025, https://www.racgp.org.au/advocacy/reports-and-submissions/view-all-reports-and-submissions/2022-reports-and-submissions/submission-to-medical-board-consultation-regulatio. ↩
10. Medical Board of Australia / Ahpra (2023–2025), Guidelines for registered medical practitioners who perform cosmetic surgery and procedures and related FAQs, Medical Board of Australia & Ahpra, viewed 2025, https://www.medicalboard.gov.au/News/FAQs-New-cosmetic-surgery-guidelines.aspx. ↩