One of the strongest characteristics of youth is fullness of the cheeks. The cheekbones are largely responsible for defining your face, highlighting the eyes and creating balance with your other facial features. A deficient cheek structure can make your face appear drawn and gaunt. Augmenting your face’s bony prominence such as cheeks, brows or chin can improve upon your overall facial harmony dramatically. Cheek augmentation can be done by itself or may be part of a face lift or other facial surgery.
Making the Decision
There are three general shapes to cheek implants: malar, submalar, or combined. Malar implants, the most common shape, are placed directly on the cheekbones to provide more projection to the cheekbone area. Submalar implants are not placed on the cheekbones themselves but rather directly below the bony prominence with the intent to augment the mid-face to create a sense of fullness. This is especially beneficial if the person has a gaunt or "sunken" appearance to this area. Combined implants or malar/submalar combination, are often chosen to augment both the midface and the cheekbone area.
For a less invasive approach, cheek augmentation may be done in the surgeon’s office utilizing a variety of injectable fillers, which is not considered to be permanent. Autologous fat transfer is another approach where the surgeon utilizes fat from another area of the body and prepares it for re-injecting into the face in a sterile environment. The fat is extracted by liposuction, fat cells are isolated and then prepared to be re-injected into the body. To be considered long term, autologous fat transfer should be done multiple times.
Understanding the Surgery
A qualified facial plastic surgeon can help determine your needs by examining your facial structure. During your consultation, your surgeon may examine your cheeks, facial muscles or tug at your skin to determine elasticity. As with all elective surgery, good health and realistic expectations are prerequisites. Your surgeon will provide you with realistic expectations of the selected procedures and can also simulate potential results through our state-of-the-art imaging technology. Your cosmetic surgeon will choose the implant according to a preoperative analysis of your facial size and structure.
To place the implant, the surgeon creates a pocket between the cheekbones and its overlying soft tissues where the implants are then placed. How and where the incisions are made will be determined by area of placement and other combined procedures.
Cheek implants can be made of a variety of materials, the most common of which is silicone. In addition, two popular options are high-density porous polyethylene, marketed as Medpor, and ePTFE (expanded polytetrafluoroethylene), better known as Gore-Tex. Both Medpor and ePTFE are inert substances, providing better integration with the underlying tissue and bone than solid silicone. However, in the case of Medpor, the implants' integration with the underlying tissue causes difficulty removing the implant if revisions are needed.
After the decision to proceed with surgery is made, the surgeon will describe the technique indicated, the type of anesthesia, the surgical facility, any additional recommended surgery, risks and costs.
What to Expect After Surgery
Strenuous activities will be prohibited for two weeks after the surgery. This procedure is performed as an out-patient and is completed within a couple of hours. There will most likely be bruising, swelling and possible temporary numbness. Recovery period is usually 7-10 days initially with about six weeks for complete healing and reduction of swelling. Liquid diet is recommended for the first week as movement of the lips and mouth will be limited. Asymmetry, although uncommon, is a risk with all forms of cheek augmentation. Although a temporary loss of sensation is common, an extended loss of sensation is a possibility.
Keep all post operative appointments as scheduled. Anything unusual should be reported to your doctor immediately.