Filler in Cheeks to Lift Jowls? What a Peanut-Shaped Face Needs

I'm Dr. Hongseok Kim, a board-certified dermatologist with 21 years of practice and the medical director of VOS Dermatology Clinic in Gangnam, Seoul, right in front of Dosan Park. I consult and treat every patient myself, and "Doctor, I think I look older than I am" is something I hear almost every day. Very often the reason is a face shape that Koreans call a "peanut face": prominent cheekbones with hollows above and below them.

Many people then ask whether they can simply use filler in cheeks to lift jowls. My answer is that this face usually needs facial balancing instead: filling what has sunk, lifting what has dropped and looking at the jaw and chin, so the outline reads as one smooth oval. This page is based on my YouTube video from July 2025; it summarizes what I explained there for readers abroad. The video above can be watched with translated captions.

What a peanut-shaped face is, and why it happens

Short answer: it is a face where the cheekbones stand out while the temple above and the cheek below have sunk in, so the outline goes in, out, in, out, like a peanut shell.

On a bare skull (in the video at 00:16) the cheekbone sticks out and the areas above and below it are empty; fat, muscle and fascia normally fill them and soften the line. If you have dieted repeatedly, lost a lot of weight or have always been very slim, that fat layer is thinner. The temple drops in, the cheekbone stands out right above it, and the cheek below it sinks.

Young people can have this shape too, but it usually becomes clearer with age. Ageing is not only fat loss and weaker skin. Bone is also resorbed, so the tissue that used to rest on the cheekbone loses its support, and fat that was held in place sinks and sags. So a peanut face is usually two problems at once: hollowness and sagging. In principle the answer is simple: fill what is hollow and lift what has dropped.

Can cheek filler lift jowls, or is Juvelook Volume enough?

Short answer: filler mainly adds volume and does little to lift, and Juvelook Volume suits the front of the cheek well, but the outer cheek below the cheekbone often needs more.

For years the main approach was to fill hollows with filler (in the video at 03:14). Filling makes the cheek look full, and right after treatment the shape can look very good. But when the hollows are deep, it can take a large amount of filler, and the surrounding tissue does not always adapt to that weight. Over time some faces start to droop, which can look less natural and even older. That is the "filler face" many people are trying to avoid, and it is why I don't rely on filler alone to lift a sagging cheek.

Filler still suits some people, and I do use it, but many of my patients would rather avoid it, so I need other options.

What about Juvelook Volume alone? Look at your face from the front. There is a faint ligament around the cheekbone, and the tissue in front of it and behind it behaves very differently. The front cheek is softer, and with repeated Juvelook Volume sessions the skin there becomes firmer and more elastic. The outer cheek, the part that makes the peanut outline, is firmer tissue with stronger attachments, and treating it with Juvelook Volume alone takes a large amount or a long, repeated course.

I explain it with paper: strong skin is like cardboard and holds its shape, while weak skin is like rice paper and sinks with a small loss underneath. Juvelook Volume placed fairly high turns rice paper into something closer to cardboard, and placed a little deeper it can support the fat underneath. For a mild peanut face that can be enough with repeated sessions. In more marked cases the result can look natural but leave the outer hollow behind, or take a long time.

Stronger options for the outer cheek: PLLA, calcium-based stimulators and PCL

Short answer: stronger collagen stimulators can reshape the outer cheek, and which one fits depends on how fast you want change and how often you can come back.

For the outer cheek and the cheekbone outline, one of the options I use most is PLLA (poly-L-lactic acid), the ingredient in Sculptra (in the video at 06:47). People often search for it as "PLLA filler", but it works as a collagen stimulator rather than a gel that fills on the spot. It is stronger than Juvelook Volume, but it is not a one-session correction: it takes two or three sessions and time for the skin to respond. It suits people who have time and want a very natural change, not those who need a quick result or can't return often. My note on who PLLA treatments suit explains that choice.

When someone wants faster change, I often use a calcium-based stimulator, treating not only the hollow but also the temple so the whole outline improves. It keeps working for about six months, so I check at that point and add another session if needed. The response is stronger and the visible effect comes sooner than with Juvelook Volume or PLLA.

Another option is PCL (polycaprolactone). Earlier PCL products had reports of nodules, which slowed their use. Lafullen contour fixing uses PCL with more evenly sized particles, gives a quicker visible effect, and its results last about one to one and a half years; swelling for a few days is normal and varies by person. In short: a mild peanut face may be covered by Juvelook Volume, a moderate one often does better with PLLA, and a marked one, in someone who wants faster results without filler, may suit a calcium-based stimulator or Lafullen.

The jaw and chin: the other half of facial balancing

Short answer: relaxing a strong jaw muscle and softening a short chin can do as much for the outline as treating the hollow.

Once the hollows are addressed, look at the jaw (in the video at 09:42). If the jaw angle sticks out, botulinum toxin in the jaw muscle makes it slimmer, and together with a softer upper hollow, the face gradually moves from a peanut shape toward an oval one.

The chin matters too. If the line breaks off at a receding chin or the chin is short, a small amount of hyaluronic acid filler in the chin can make the whole line much smoother. Whether that is needed depends on the shape of your chin.

Lifting the jowls: does Ultherapy make hollow cheeks worse?

Short answer: lifting is often the part that actually raises what has dropped; the hollowing people worry about is linked to treatment that is too strong or done without assessing the face first.

Think of a balloon filled with water (in the video at 10:54): the weight pulls it down. As the outer cheek loses volume and support, the face drops, and the front cheek loses volume too. Correcting only the outer cheek helps, but it will not feel lifted. For that, I use high-intensity focused ultrasound such as Ultherapy, which targets a deep layer and lifts along a vector, and when skin elasticity is low I may add Sofwave.

Hollowing after Ultherapy can happen when it is done too strongly or without looking at the face. In my plans the contour is usually supported first with a skin booster or collagen stimulator, and I assess it for every face. My page on Ultherapy side effects covers what is normal afterwards, and my Dr. Kim TV note on Korean lifting before a flight home covers timing around travel.

Why facial balancing usually means a combined plan

Short answer: no single treatment covers every part of this face shape, because face shape, age, elasticity and volume differ from person to person.

A peanut face is the combined result of several factors (in the video at 12:27), so I look at the pattern first and then decide which treatments to combine. A wide face with deep hollows is a good example: filling everything can make it look round, the pillow face no one wants. Then I may use only jaw muscle relaxation, or lifting with Ultherapy or Sofwave, aiming to make the hollow less visible rather than fully corrected.

If you are planning this in Korea around a trip, my guide to facial balancing Korea consultations covers what to sort out before the flight, and you can send your concern and a photo on WhatsApp first for a quote before anything is scheduled. To see how other visitors' treatments went, our creator experiences at VOS have their stories.

Results vary from person to person, and which treatments you need is decided at an in-person consultation.

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Results, swelling and recovery vary from person to person. This page is general information from VOS Dermatology Clinic based on Dr. Kim's video and does not replace an in-person consultation.