Actual RealSelf Patient Comment: I had a product similar to bellafill about 15 years ago, and the volume is fine, but when I smile it looks very unnatural because the product was injected right under the skin. I’m in the process of having it removed, but want to have a replacement of volume that doesn’t move and look huge and unnatural when smiling. Is it possible to have filler in the cheeks that doesn’t move when animating the face, or will I need an implant?

Dr. Persky’s Reply: Your first step is to have the offending filler removed, which with Bellafill is difficult. There are fillers that are “expressive”, one of which is Restylane Defyne. The other technique to avoid filler moving unnaturally on expression to have the proper filler injected at the proper level (an example is having Sculptra or Voluma injected deep below muscle and over bone.). My best advice is that patients must choose their injecting physician very carefully in the first place.