Board Certified Plastic Surgeon
Recommended for: Board Certified Plastic Surgeon +-1
James M. Economides, MD, FACS is an award-winning Board Certified plastic surgeon in Arlington, VA just outside Washington, DC. He is known for cosmetic surgery of the breast and body with a particular interest and expertise in mommy makeover, breast augmentation, tummy tuck, and liposuction. He also has a strong interest in facial rejuvenation, face lift and neck lift. In addition to surgery, Dr. Economides is skilled in nonsurgical cosmetic procedures such as Botox®️ and dermal filler injections.
Dr. Economides is a lifelong resident of Washington, DC.
A lifelong resident of the Washington, D.C., area, Dr. Economides earned his bachelor’s degree with honors from Georgetown University in Washington, D.C. He then completed medical school at Georgetown University School of Medicine and the fully integrated plastic surgery residency program at Georgetown University Hospital. He spent clinical rotations at several world-renowned specialist hospitals including the microsurgery center at Chang Gung Memorial Hospital in Taipei, Taiwan, the Curtis National Hand Center in Baltimore, MD, and Children’s National Medical Center in Washington, DC.
Beyond surgery, Dr. Economides regularly shares his knowledge presenting at national and international conferences, reviews scholarly articles for plastic surgery publications, and writes dozens of scholarly articles and textbook chapters in the field of plastic surgery.
He loves to cook and travel with his family and friends.
Patient trust score
3 skill endorsements
1635 N George Mason Dr., Ste. 380, Arlington, Virginia
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I understand your concerns about the various options for achieving fuller, rounder "baby cheeks," especially given the conflicting advice and risks associated with different treatments. Here's a breakdown of the available options and alternatives that might help you achieve the look you want, focusing on safe and effective solutions for your goals. 1. Cheek Fillers (Hyaluronic Acid-Based): Voluma or Restylane Lyft: While Voluma is commonly used for cheek augmentation, it is true that some practitioners avoid placing it directly in the buccal area because it can create an unnatural or overfilled look in this region. However, fillers like Voluma or Restylane Lyft can still be used in the midface or cheekbones to create a more rounded appearance if done conservatively. Pros: Reversible with hyaluronidase, immediate results, customizable for a natural look. Cons: Temporary, with results lasting 12-18 months, and should be done by an expert injector to avoid the "puffy" or unnatural appearance. 2. Fat Transfer: Fat Grafting: While you're understandably hesitant about fat transfer due to weight fluctuations, fat grafting can still be an option. When done by an experienced surgeon, fat can be precisely injected into the buccal and cheek areas to achieve the fuller, rounder look you want. Pros: Long-lasting (potentially permanent) results, natural-looking fullness. Cons: Some of the fat may not survive the transfer, and there's a small risk of asymmetry. Weight changes can affect the fat graft over time, but results can be stable with weight maintenance. 3. Combination Approach: Cheek Filler with Buccal Fat Preservation: Instead of focusing on the buccal area directly, a skilled injector could use fillers in the malar region (the upper part of the cheek) to lift and enhance the natural cheek contour. This combined with minimal filler in the lower cheek could give the full, round appearance without overfilling. Pros: More control over the outcome and ability to blend volume throughout the face. Cons: Requires a highly skilled injector to balance the look. 4. Sculptra: Collagen Stimulator: While you mentioned fat transfer as a concern, another option is Sculptra, which works by stimulating collagen production in the injected areas. It’s not an immediate filler, but it gradually builds volume and can give a more natural, long-lasting result. Pros: Gradual and natural volume increase, long-lasting (up to 2 years or more). Cons: Takes multiple sessions to see results, and it’s not reversible like hyaluronic acid fillers.
Yes, filler injections in the hollow of the cheeks can potentially cause bruising, but there are ways to minimize the risk. Bruising occurs when the needle or cannula used during the injection hits small blood vessels beneath the skin. Several factors, including the injection technique, play a role in whether bruising happens. 1. Administration Technique: Cannula vs. Needle: Using a cannula instead of a needle can reduce the risk of bruising. Cannulas are blunt-tipped and less likely to puncture blood vessels compared to needles, making them a popular choice for areas prone to bruising, such as the cheeks. Experienced Injector: A skilled injector familiar with facial anatomy will be more likely to avoid blood vessels during the injection, minimizing the chance of bruising. The injector's technique, such as injecting slowly and avoiding over-manipulation of the tissue, can also help reduce trauma to the area. Layer of Injection: Injecting the filler deeper into the tissue, where there are fewer superficial blood vessels, can also lower the risk of bruising. 2. Ways to Avoid Bruising: Avoid Blood Thinners: Stop taking aspirin, ibuprofen, and other blood-thinning medications or supplements (like fish oil or vitamin E) for about a week before the procedure, unless medically necessary. Avoid Alcohol: Refrain from drinking alcohol for at least 24-48 hours before your injection, as it can thin the blood and increase the likelihood of bruising. Cold Compresses: Applying a cold compress to the area before and after the injection can constrict blood vessels and help prevent bruising. Arnica or Bromelain: Some people use Arnica gel or Bromelain supplements before and after the procedure to reduce bruising and swelling. Post-Treatment Care: After the procedure, avoid strenuous activity, excessive heat (like saunas), and massaging the area for the first 24-48 hours to minimize trauma. 3. Expectations: Even with all precautions, some people may still bruise due to their skin’s sensitivity or underlying vascularity. However, working with an experienced injector who uses appropriate techniques (like a cannula) and following pre- and post-care instructions can significantly reduce the chances.
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