Facial Surgery: Cheek Implants

Philosophy: My philosophy for facial implants is that they should be positioned in a space created immediately above the bone. They should be immobile and not placed in the loose tissues of the face so that they move around. The patient should be unaware of a foreign substance and the implant should be a seamless part of their body shape and image.

Age Group: Cheek augmentation is indicated for two distinct groups: Young adults with deficient cheek development. These patients may also need a simultaneous reduction of the nose. Young and older patients with poor definition of the cheek area who may also require lower facelift.

Surgical Technique: A small incision is made inside the upper lip. A space is created next to the bone for the implant. The space is washed with antibiotic and the implant is positioned. After making sure that the size and position of the implant is ideal, the wound is closed. In the case of patients requiring tightening of the face at the same time the procedure may be combined with a lower facelift.

Implant: A solid silicone implant is used. This type of implant is easily placed without excessive trauma to the tissue and it can be removed or changed without difficulty. A wide range of sizes and shapes is available to create the best contour for that particular individual. Three types of implant are used; a malar shell which covers the entire cheek bone area, a submalar implant which fills in the hollow beneath the cheek bone or a combination of the two.

Options: Injections of Perlane or New-Fill may allow soft tissue correction but the results last for 6-24 months and are not permanent. The result is less predictable although no surgery is required. Fat injection is inconsistent and results may be short-lived.

Recovery: Bruising is usually minimal but can occur. Swelling lasts for about two weeks. The contour will continue to change after this point and the final appearance will not be apparent until six months after surgery.

Risks and complications: Potentials risks of all surgery are bleeding and infection. Specific risks of placement of a cheek implant are damage to the nerves providing sensation and movement to the upper lip. Surgery is performed in the space next to the bone so that the implant is safely positioned and the nerves are protected. The infra-orbital nerve which provides sensation is identified and by using the space next to the bone and the underlying masseter muscle, the facial nerve which provides movement to the face, is protected as it passes above. Transient weakness of both nerves is possible after surgery. Other risks of surgery are asymmetry of the implant, wrong position or wrong size. For these reasons all of these factors are evaluated during surgery to obtain the best result. Please see our consent form (link) for a detailed description of potential risks and complications.

Related procedures: Cheek implants can be combined with a facelift or other facial plastic surgery