PERHAPS the pretty things traipsing up and down Robertson Boulevard don't quite know yet that their poufy, pulpy lips are so 2006.
Today, it's all about the cheekbone.
In yet another phenomenon in cosmetic procedures -- taking off from Botox, eyelash extensions and, of course, those collagen-injected lips -- women (and plenty of men) are taking another look at their cheekbones, using injectable fillers to help shape, plump and generally restructure the cheek -- an area that has until now been overlooked.
At the heart of the upswing, doctors say, is that people are no longer fixated just on the lines and wrinkles in their face, but in how to get the effect of a full face-lift without going under the knife. The general obsession with celebrity culture is helping to drive cheekbone mania too: Surgeons often get requests from patients specifically to replicate the spectacular cheekbones of Angelina Jolie or the rosy, youthful cheeks of Katie Holmes or Jessica Alba.
"When Bo Derek came out in '10,' everyone was thinking about the cheekbone, but it fell out of favor," said Dr. Anna Guanche, a dermatologic surgeon and owner of the Bella Skin Institute in Calabasas, who later this month will perform a cheek procedure on TLC's makeover show, "10 Years Younger." "What's happening now is that people are focusing on more than just the obvious areas like around the eyes, the smile lines or the forehead. They are noticing that their cheeks are rolling downwards and inwards as they age, and that something can be done about it."
The procedure involves one or two injections around the cheekbone area, either through the face or, as some cosmetic specialists practice, through the mouth. The area is anesthetized so there is minimal discomfort. It rarely takes longer than 20 minutes, and though there might be some short-term redness, the effects are almost immediate. No recovery time is needed.
Among the more popular fillers are Radiesse, an FDA-approved injectable made from calcium hydroxyapatite -- essentially calcium-based microspheres in a water-based gel. Originally designed to smooth out wrinkles and lines (specifically, the nasolabial folds, which form around the mouth and nose area), the dermal filler is now being used increasingly above the cheekbone to add definition. A cheek procedure with Radiesse will run $1,500 to $2,000, with results lasting a year or longer. Other fillers include Sculptra, also FDA-approved, which is made from poly-L-lactic acid and tends to be pricier but does last longer. Side effects can include occasional redness, swelling and discomfort around the injected area, and in cases where the injection is done through the mouth, doctors say there is also a chance of infection.
Dr. Bruce Katz, director of the Juva Skin & Laser Center and MediSpa in New York, says he has performed three times as many cheek procedures in the last year as he had done previously. His clients are split into two categories: those who want cheek fillers to try to counteract the effects of aging, and younger people who want to emulate celebrity cheekbones.
"Those nice high cheekbones give the face an almond shape that's very attractive," he says. "A lot of women in the past haven't realized that their cheeks are going to sag as they age, and younger women want to have prominent cheekbones," he added, citing ideals as Nicole Kidman and Sophia Loren.
"I've always admired those actresses with the amazing cheekbones," says a 36-year-old Los Angeles actress and stuntwoman who did not want to be named. "It's looked at as really beautiful and striking. A part of me wanted a little piece of that." She had the procedure done five months ago, and then a more recent touch up. The result, she says, is "more defined cheekbones and a chiseled line. I like me a little better now."
Angela Wolf, a 42-year-old Los Angeles sales and marketing executive, began noticing drooping skin and heavy lines on her face. She was first advised to have cheek implants but instead opted for the far less invasive fillers. "For someone who doesn't want to do an extreme surgery, this makes such a wonderful difference," she says. "I have more volume in my cheeks and my face doesn't look droopy anymore."
Indeed, the fillers may well spell the end of cheek implants, which are more expensive, permanent and require major surgery.
"We don't have to do cheekbone implants and face-lifts anymore," says Dr. Phil Werschler, a cosmetic dermatologist and clinical investigator in Spokane, Wash., and former president of the American Society of Cosmetic Dermatology & Aesthetic Surgery. "Today, the most important component of facial shaping is to put product along the cheekbones and lower eyelid, and that lifts and redefines the whole face."
And it's not just surgeons and dermatologists who are seeing the focus shift to the face. Hair, makeup and skin care experts are noticing, too.