Avoiding malar edema during midface/cheek augmentation with dermal fillers

As dermal fillers have evolved, volume restoration and contour enhancement have become the objective of advanced injectors. The value of injections of dermal fillers into the midface is well documented in the literature. However, the midface, particularly the infraorbital hollow, is the facial area most prone to adverse events from filler treatment. Malar edema is a particularly significant and long-lasting untoward event that is frequently reported. This article reviews the anatomic basis for malar edema, relates it to filler injection technique, and presents the author's preferred method of injection to help ensure avoidance of this adverse event.