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Cheek Augmentation: The Procedures Explained

Medically reviewed by Jennifer Richman on October 6, 2025.

Understanding Cheek Augmentation Surgery

Cheek augmentation surgery is designed to permanently increase the volume and projection of the cheeks. Cheek volume has no gender. However, many transfeminine patients seek out cheek augmentation as a part of their facial feminization surgery (FFS) to give the face a softer, more feminine appearance. For many transmasculine patients, cheek implants can give the face a more angular, conventionally masculine appearance as a part of facial masculinization surgery (FMS). Cheek augmentation surgery can compensate for a hollow or sunken appearance in the face, which is sometimes an effect of aging.

If you are interested in undergoing facial fat grafting or implant surgery to augment your cheeks, you can request a free consultation with one of our board-certified surgeons today. Gender-affirming facial surgery patients have consistently reported high satisfaction rates, improved self-image, higher self confidence, and reduced gender dysphoria after they make it past the difficulties of the recovery process.

Cheek Augmentation for Facial Feminization Surgery

Cheek augmentation through implants or fat transfer is one of our most commonly requested procedures for FFS. After all, in an estrogen-dominant puberty, fat often redistributes to increase the fullness of the cheeks. As a result, the cheekbones often sit higher and appear more prominently on the face.

Transfeminine people who take estrogen hormone replacement therapy will start to see body and facial fat redistribute about 3-5 months after starting treatment. If you are not microdosing, it can take anywhere from 2-5 years of estrogen hormone replacement therapy (HRT) for your fat to finish redistributing. For this reason, we often recommend patients to wait until they have been on HRT for at least a year before considering a cheek augmentation.

The Procedure: Fat Transfer Cheek Augmentation

Surgical Technique

With fat transfers, our surgeons use liposuction to harvest and purify fat from other parts of the body––most commonly the abdomen––and deposit it into the cheeks.

Scarring

Your surgeon will use a thin tube and needles to extract and inject the fat. Incisions are very small and will often heal to be completely invisible.

Long-term results

This option for cheek augmentations yields semi-permanent results. Usually with this procedure about 50-60% of the transplanted fat will survive the transplant.

Recovery considerations

A patient can try to optimize their chances of good fat survival by avoiding strenuous activity for 4 weeks following this procedure.

The Procedure: Silicone Implant Cheek Augmentation

The technique

Silicone cheek implants are surgically attached with sutures or a screw to the patient’s zygoma, or cheekbone. Implants can be placed on the malar area (at the height of the cheekbone) to increase the volume of the apples of the cheeks. Silicone implants can also be placed in the submalar area to fill out hollowed-out cheeks.

Scarring

To insert the implants, two incisions are typically made inside the mouth, above the upper gums. As a result, this procedure leaves no visible scars.

Long-term results & reversibility

Once implants are placed, their results are permanent. Unlike fat transfers, the insertion of a silicone implant is completely reversible.

Recovery considerations

The advantage to having internal mouth incisions is that they leave no visible scars. However, during the initial stages of recovery, you will need to follow certain precautions like eating a soft diet to care for these incisions.

Potential Risks and Considerations

Like any facial surgery procedure, there is a slight probability of risk. We encourage patients to be honest with your surgeon about your medical history during your free consultation; that way, we can ensure you are safe during and after surgery.

• Prevention: There are many steps that patients can take before surgery to lessen their risk of complications. For example, quitting tobacco can help prevent issues with delayed healing and tissue necrosis (i.e., fat that is transferred into the cheeks not surviving and holding in place).

• Common recovery experiences: Cheek augmentation patients should expect to experience temporary facial bruising and swelling in the surgical site during the recovery period.

• Less common complications: Patients may also run the risk of experiencing infection, seromas (fluid build-up), hematoma (bleeding), adverse reaction to anesthesia, eye irritation or changes in skin sensation.

Cheek Augmentation Fillers: A Non-Surgical Alternative

Weighing your options: surgery vs. fillers

Unlike gender-affirming surgery, temporary facial fillers are not offered by the Gender Confirmation Center (GCC) at this time. Likewise, since they are not a surgical procedure, insurance will not cover these as a form of gender-affirming care. Since fillers are temporary, they can help a patient determine if a permanent, surgical modification would be a good fit for them.

However, temporary fillers are a more economical option for patients. In general, filler is less expensive than fat transfer because the patient will not need to pay for the operating room or anesthesia associated with fat transfer. However, with repeated filler injection, there might not be cost savings.

Technique

There are a variety of different available types of filler, with each staying in the body a different amount of time (ranging from 6 months to two years). When fillers are used to augment the cheeks, patients are not required to adhere to any activity limitations. Fillers are also an outpatient procedure, meaning if patients just want cheek fillers these can be placed in the office without any need for anesthesia.