Case Studies

Cheek Implants

For those with deficiency in the mid 1/3rd of the face, cheek implants offer an excellent opportunity to create desirable contours in the planes of the face.  However, correction with the addition of bulk in this area must be cautiously done or it will look heavy and unrealistic.  Implants for use in this area are usually made of silicone or other non-reactive materials that have been shaped prior to insertion at surgery.

How much cheek prominence is normal?  There are no mathematical formulas or engineering drawings that will answer this question in any single individual.  It all boils down to what looks best for the unique contours of your face.  No one has ideal contours for all measurements of the facial features.  There are drawings that purport to show the ideal female and male aesthetic but in real life very few come close to these ideals.

Before Surgery

Your first consultation will focus on determining whether cheek implants are desirable and, if needed, what size and shape will offer the best correction for your individual deficiency.  Since you cannot insert a trial implant to determine the effect of placing a cheek implant, you are going to have to trust mostly to the aesthetic eye of your plastic surgeon and his or her experience.  On a few occasions, I have resorted to injection of a very small amount of sterile saline into the cheek tissue to simulate as close as possible the addition of a cheek implant so that the patient can see what can be obtained.  It is a fleeting moment as the saline is absorbed rapidly by the body and there will be nothing left to see very quickly.

Of course, your input is the starting point of the entire discussion.  Just what is it that you are trying to achieve?  More prominence of the cheek?  Widening of the area?  Greater thickness of the cheek in the vertical dimension?  Try to be as definitive in verbalizing your interests as possible.  Make sure you are communicating your desires with your doctor.  Then let him explain what can be done from the surgical side.  And what cannot!

Most cheek implants are made of silicone as it is flexible and will contour to your own cheek bone.  I find these to be easier to insert than others and should a problem arise that the implant must be removed or repositioned, silicone is easy to remove whereas ridged implants are not.

The Surgery

Cheek implants are usually inserted through an incision inside the mouth just above the teeth on either side of the nose.  General or local anesthesia can be used but I prefer a general as this is the way I would want to have it were I the patient.  The tissue overlying the maxilla along with the periosteum (covering of the bone) is lifted and a pocket developed that is the exact shape and size of the implant to be inserted.  There is almost no bleeding in this plane.  The implant is inserted and anchored in place with a couple of stitches.  The incision is closed.

Post Surgery and Recovery

Most patients who are having cheek implants without other procedures are done as an outpatient and may return home following recovery from the anesthetic.  (Patients may choose to stay in the Hospitality Suite in order to have assistance with the immediate postoperative care.)  Most important are the ice compresses that are applied to the operated area in order to reduce to a minimum the swelling and bruising that follows any surgery.  Ice compresses are applied continuously for 48 hours following the operation using crushed ice in gauze or a facecloth.  Following 48 hours, the ice is discontinued and warm wet compresses are applied for 20 minutes four times a day to facilitate diminution of the edema and bruising that has occurred.    Patients will find that swelling slowly declines over 2-3 weeks after the operation.  Expect the implants to look too large during this period.

There are instructions for each aesthetic surgery procedure that are given to each patient.  Follow these instructions exactly as they are designed to speed your recovery and to prevent postoperative complications.  You will not go to Florida for a postop vacation in the sun while healing.  In other words, follow my directions so that you are ready to return to work and society in the expected time of 1-2 weeks.

Risk and Complications

This is a surgical procedure and therefore complications may occur.  I can’t imagine how many times I have said this to patients during the consultation.  Frequently about this time, a glaze comes over the eyes and the patient “tunes out”.  Risks of surgery and possible complications are not the most pleasant thoughts when you are excited about getting your new look but my advice, pay attention.  The cause of a complication may not be something done at surgery, but rather something you inadvertently do in the postop period.  Serious complications such as infection or life-threatening situations are extremely rare.  Most “complications” are actually something that delays healing and therefore the patient is inconvenienced because they cannot return to work or to their usual social life as soon as expected.  The list of usual complications and their causes are covered in detail at the consultation so listen attentively.

The Cost

When budgeting for cheek implant surgery, remember there is the fee for the surgeon, the cost of the implants, the cost of the surgery facility and the fee for the anesthesiologist.  There are miscellaneous other costs such as lab tests, medications, preop physical, postoperative caregivers, etc.  Once you are seen in consult and all factors evaluated, a final cost will be quoted for you.  If you would like to get a general range of fees, please call the office at 404-252-3672 and ask for the patient coordinator as she will be able to ascertain your general needs and give you a baseline average cost.

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