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Can Cheek Fillers Cause Sinus Problems?

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Cheek filler injections are an increasingly popular cosmetic treatment to sculpt and define facial contours. However, some patients have reported developing sinus problems and infections after receiving dermal filler injections in the cheeks

What are Cheek Fillers?

Cheek fillers, also known as dermal fillers or injectable fillers, are gel-like substances that are injected under the skin to add volume and fullness to the cheeks and midface. Some common injectable filler products used in the cheeks include hyaluronic acid fillers like Juvederm Voluma, Restylane Lyft, Teosyal Global; collagen stimulators like Sculptra; and synthetic fillers like silicone.

These facial fillers work by filling in facial wrinkles and restoring lost volume to areas like the midface, temples, and tear troughs. Cheek fillers help sharpen cheekbones, correct age-related sagging, and achieve a more youthful appearance.

How are the Cheeks and Sinuses Anatomically Connected?

cheek filler treatment

To understand how cheek fillers can potentially affect the sinuses, it is important to consider the facial anatomy and how the cheeks, under-eye region, and sinuses are interconnected:

  • The maxillary sinuses sit directly under the cheekbones in the upper jaw.
  • The nasolacrimal ducts drain tears from the tear troughs near the cheeks into the nose and sinuses.
  • Inflammation in cheek tissues can compress and put pressure on the maxillary and ethmoid sinuses nearby.
  • Blood vessels and nerves that supply the lower eyelids, cheeks, and upper lip also feed into the nasal cavity and sinuses.

Some cheek filler injection sites are in very close proximity to the sinus openings and drainage pathways. Knowledge of the anatomy allows injectors to avoid placing fillers in locations that impede sinus function.

How Do Cheek Fillers Cause Sinus Problems?

There are several ways that dermal filler injections in the cheeks can potentially cause sinus problems:

Filler Material Entering the Sinuses

If the needle goes too deep during injection near the under eyes or cheekbones, filler gel can accidentally be injected directly into small blood vessels and capillaries that drain into the sinus tracts. This introduces foreign material and raises infection risk.

Swelling and Inflammation

Inflammation and edema (swelling) are normal short-term reactions to tissue filler injections in the cheeks. However, excessive swelling can put pressure on nearby sinus cavities and obstruct mucus drainage channels. This can lead to clogged sinuses and pain.


Poor injection technique, non-sterile needles, and external bacteria introduced during the procedure can all lead to infections like sinusitis after cheek filler injections. Chronic infections and biofilm are harder to treat.

Allergic Reaction

Some people may have undiagnosed allergies to ingredients in specific types of dermal fillers. Allergic reactions cause inflammation, sinus irritation, congestion, facial pressure and headaches after cheek filler injections.

Pressure on Sinuses

Over-filling the cheeks with excessive amounts of filler beyond normal facial contours can physically compress, squeeze and put pressure on the maxillary sinuses behind the cheekbones. This impedes drainage and causes obstruction.

Blocked Tear Ducts

If cheek fillers obstruct the nasolacrimal ducts and prevent proper tear drainage from the under eye area into the nose, it can cause fluid buildup, swelling and infection risk in the sinuses.

What are the Side Effects and Risks of Cheek Fillers?

While considered relatively safe, cheek filler injections do carry potential risks and side effects, both temporary and long-lasting. These may include:

Common temporary side effects:

  • Swelling, bruising, redness at the injection site
  • Pain or tenderness in the treated area
  • Headaches, numbness, tingling immediately after treatment

Rarer long-term risks and complications:

  • Asymmetry, irregular contours, and filler migration
  • Infection - if proper sterile technique is not followed
  • Biofilm formation and chronic inflammation
  • Vascular occlusion from accidental injection into an artery
  • Skin necrosis and tissue damage from excessive filler material
  • Allergic reaction, hypersensitivity to specific filler ingredients
  • Granulomas - inflammatory nodules that may form weeks later

Signs of Sinus Problems After Cheek Fillers

Patients who receive cheek dermal filler injections should watch for these warning signs of sinus issues afterwards and contact their provider promptly if they occur:

Facial pressure, congestion, blocked sinusesObstructed sinus drainage pathwaysNasal sprays, sinus rinses, decongestants
Sinus pain, headaches in cheekbone regionInflammation or swelling putting pressure on sinusesAnti-inflammatories, warm compresses
Swelling, puffiness in cheeks, under eyes, midfaceAllergic reaction or improper filler placement compressing sinusesAntihistamines, filler dissolution
Impaired breathing, reduced smellNasal congestion, obstruction of sinus tractsNasal corticosteroid sprays, sinus rinses
Green/yellow nasal dischargeSinus infection, potential bacterial causesAntibiotics, nasal saline rinses
Fever, chillsInfection, body's inflammatory responseAntibiotics, antipyretics
Worsening chronic sinus infectionPre-existing condition aggravated by filler placementAntibiotics, nasal sprays, sinus surgery if needed

The table above lists some common signs of sinus problems after cheek filler injections and what they may potentially indicate as well as possible treatment options

However, it is very important that patients do not attempt to self-medicate or self-treat these sinus issues if they arise. The treatments listed are only a general guide and patients should always consult with their cosmetic filler provider or another physician first before taking any action. The doctor will be able to accurately diagnose the cause of sinus symptoms after cheek filler injections and determine the most appropriate personalized treatment plan which may differ from patient to patient.

Preventative Steps to Reduce Your Risk of Sinus Problems with Cheek Fillers

As we all know, prevention is easier than cure.

There are ways to mitigate risks and maximize safety when you get cheek fillers. Trying to follow these preventative tips can help reduce the chances of developing sinus problems or other issues after cheek filler injections.

  • Do thorough research and choose an experienced, reputable injector with extensive training in facial anatomy. An expert injector will know how to properly place fillers to avoid inadvertent injection into blood vessels or blockage of sinus drainage pathways.
  • Have an in-depth discussion about your full medical history with your provider. Be sure to inform them of any past or current issues with sinusitis, allergies, sleep apnea or any other conditions that may increase your risks of sinus problems. Providing this information allows the injector to take extra precautions.
  • Get any acute sinus infections completely addressed before receiving cheek fillers. Resolve any inflammation or congestion beforehand through medication and treatment to prevent exacerbation of sinus issues after filler injections.
  • Consider avoiding filler injections if you have a cold, flu or any illness until it has fully passed. Your immune response when sick can increase risks of complications and sinus problems from fillers. Wait until health is restored.
  • Apply cold compresses to the cheeks and under eyes after your treatment. Using ice helps minimize swelling, inflammation and pressure on the sinus cavities. Discuss other post-procedure care with your provider.
  • Sleep propped up with extra pillows for 2-3 nights after your injections to keep your head elevated. This reduces gravity's effects on sinus pressure and drainage when lying flat.

While no cosmetic treatment is completely without risk, taking steps to prevent problems with cheek fillers rather than deal with them after the fact will lead to much better outcomes. If you keep this preventative guidance in mind, you'll be in a great position to enjoy the aesthetic benefits of cheek fillers while minimizing the risks of annoying side effects. A little bit of prevention planning now pays off with better safety and peace of mind later.

Consult with Dr. Lanna Aesthetics 

a man's face after cheek filler treatment

If you are considering cheek fillers, try consulting with  Dr. Lanna Aesthetics in New York City

During your consultation, your medical history, facial anatomy, and treatment goals will be thoroughly evaluated to determine the optimal filler amounts and injection approach for your cheeks while minimizing sinus complications. With her deep knowledge of facial structures and extensive experience with fillers, Dr. Lanna can help you realize beautiful, natural-looking results from cheek fillers without ever worrying from sinus problems.

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