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.
More information for facial plastic surgery procedures.
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Body Contouring Procedures 
