Posts Tagged ‘cheek augmentation’
Friday, August 19th, 2011
Q: Hi Doctor Eppley, can the type of cheekbone and jaw angle advancement be done without implants but with the patients own bone? Such as with a cheekbone osteotomy? Also, do you have any before and after pics of this kind of procedure. I would like the male model look, but I have relatively flat and narrow cheekbones and a weak chin. I am currently undergoing orthodontic treatment and will eventually have a rotational advancement of my jaw, but this will not necessarily improve my cheekbones –do you perform cheekbone advancement widening? And could you send me some before/after pics of such results? Thank you very much for any help! I would certainly be willing to travel to consult with you.
A: Most facial bone augmentations can only be done using synthetic implants on top of the bone. The one exception to that is the chin where the option exists of either a chin osteotomy or chin implant. This is because there is enough bone to cut and move and the direction needed is a favorable one from a bone movement and blood supply concern. Such is not the case with the cheek. While the cheekbone can be cut and moved, it will only produce a widening effect and not a forward or anterolateral effect which is what most patients need and want when they undergo cheek augmentation.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek augmentation, dr barry eppley, indianapolis
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Monday, June 27th, 2011
Q: Dear Dr. Eppley, I would like to have those chiseled high cheekbones. I have looked at some implant styles online and it seems that the Medpor extended malar implant may work for me. The picture on the website product catalog shows the implant in a high and lateral position and the implant is described to augment the malar region. My surgeon told me that this kind of implant can only be placed under the cheekbone (submalar) and more towards the nose than towards the zygomatic arch and that the picture on this website shows the wrong placement of this implant design. I really don´t want submalar augmentation! Is it true that this implant design is actually a submalar implant and therefore not used for malar augmentation or can it be used for both malar and submalar augmentation? What is your experience with this kind of implant design?
A: Choosing the correct implant design and size is obviously critical for any type of facial implant procedure. This is particularly true in the cheek or malar region as this area has the most complex three-dimensional anatomy to it. It contains five zones of potential augmentation including anterior, lateral, oblique, orbital rim and submalar. Any cheek implant will affect at least three of these zones in any single design. For those interested in more ‘chiseled’ cheeks, by definition this means that the oblique and lateral zones are most important. The submalar zone should absolutely not be augmented as part of this type of cheek implant because it will create more of a rounded full cheek look rather than making higher and more ‘chiseled’ cheekbones. The type of cheek implant to which you refer will not help create the look you are after. That type of cheek implant design creates fullness on the lower or submalar cheek zone and will not achieve that higher angular cheek look.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek augmentation, cheek implants, dr barry eppley, indianapolis
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Friday, April 15th, 2011
Q: Several years ago I was involved in a cycling accident in which I landed on my face and broke a lot of my facial bones, including my jaw, nose and cheeks. My face was initially reconstructed and looked quite good, almost like it was before the accident. But after 6 months, I began to notice that my cheeks looked a little flat. This appears to have gotten worse and now they look even flatter than a year ago. I don’t like to look at myself in pictures because I look so flat in my face. I know that swelling does take many months to go away but this seems more than just swelling. Why has this happened and what can I do about it? Do you think cheek implants would be a good idea? Wouldn’t they be hard to get due to scar and the metal plates that were used to fix the bones back together?
A: It is not uncommon after extensive facial fracture repair that particularly involves the cheeks, that there is cheek flattening with time. This can happen due to the cheeks not being put back to their original projection or can even happen with the most accurate realignment of the fractured bone segments. This is the result of underlying soft tissue atrophy, particularly the fat which is very sensitive to trauma. As a result fat dies (atrophies) over time. This may make the cheek prominence, which initially looked good, become flatter as the face heals up to a year or so after the injury. Cheek implants can be a good secondary reconstructive procedure. It is important to get the right style and size of cheek implants to get a good result. It would be expected that there would be scar and even some plates and screws in the path of re-entry over the cheeks but this does not prevent the secondary placement of cheek implants.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek augmentation, cheek implants after facial fracture repair, dr barry eppley, indianapolis, plastic surgery of the cheeks
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Wednesday, April 13th, 2011
Q: Dr. Eppley, I feel like my cheeks are flat and that makes my face very non-descript and uninteresting. I think cheek implants would help but I have also read that you get get better cheeks with injectable fillers also. Which do you think is better? I have attached two pictures of my face as well as two examples of what I think are good-looking cheeks. Will cheek implants or injectable fillers worko better to reach these goasl based on the structure and limitations of my facial bones?
A: Your pictures do show malar or cheek flatness. Based on your desired goals by the pictures, cheek augmentation would definitely offer a big improvement towards improved facial balance and attractiveness. For ideal cheek augmentation and a better overall effect, an implant is the best choice in my opinion. Besides its permanent effect, it has a better economic value long-term. . If you are uncertain as to whether cheek implant surgery is for you, however, then initially have an injectable filler treatment done. Be aware that injectable fillers will not create exactly the same look as implants which have a very well defined shape. Injectable fillers create more of a less-defined mass effect although that will still be helpful to prove that cheek augmentation is or is not for you. When considering cheek implant surgery it is important to realize that there are different styles of cheek implants that accentuate subtle but different areas of the cheek. Selecting the right cheek implant and size is critical as the main reasons for cheek implant revision is improper implant selection and inadequate sizing.
Dr. Barry Eppley
Indianapolis Indiana
Tags: cheek augmentation, cheek implants, dr barry eppley, indianapolis plastic surgery of the cheeks, injectable cheek augmentation
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Wednesday, January 19th, 2011
Q: I am going to get cheek implants but am concerned about them moving around afterwards. I am an extremely athletic person who works out a lot. This involves running and jumping around a lot. I do participate in conatct sports such as basketball and flag football. However, I don’t do boxing and am not planning to get punched in the face. (who does really?) My cheek implants will be the Conform malar shell type so they are not small. Do you think just suturing them in is enough or should they be secured with screws. Which method is best for me?
A: What makes cheek implants different from other facial implants is their bony position. Sitting on the side of the cheek bone, with no bone support underneath them, makes them more prone than many other facial implants to shifting or malpositioning. This risk is magnified by their path of insertion from inside the mouth which opens up the southern avenue for shifting. While most cheek implants do not experience these problems, the risk is not zero. Because of this concern, it is my preference to almost always screw fixation for cheek implants. This makes me feel the most comfortable that the postoperative risk of implant shifting is virtually eliminated. the appeal to me of screw fixation is that it is also easy to do, involves no risk, is done at minimal extra cost, and adds essentially no extra time to complete the procedure.
Dr. Barry Eppley
Indianapolis Indiana
Tags: cheek augmentation, cheek implant screw fixation, dr barry eppley, indianapolis, plastic surgery
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Sunday, December 19th, 2010
Q: All my life I have had depressions under my eyes. It’s a hereditary thing as I have no cheekbones at all. It makes me extremely self-conscious. Although I don’t need glasses, I wear them all the time to hide this problem. I have been thinking about getting cheek implants. Do you think that will help me? I have seen some cheek implant results and they look really fake to me. How do you avoid cheek implants from looking unnatural and even making my eyes look too sunken in?
A: There is no doubt that well-defined cheekbones are an important facial component of what can make a man or a women good looking. Cheekbones help define the face by highlighting the eyes, adding balance to the other facial prominences and contributing to a look of youth and vitality.
Cheek implants can really help those whose midface is deficient. But cheek implants come in different styles and sizes. There is more to cheek implants than just choosing a size. The cheekbone is a curved structure that has dimensions of a frontal, central, posterior and inferior considerations. Different styles of cheek implants highlight these areas differently. Patients have different types of cheekbone deficiencies and that is the reason so many cheek implant styles exist. In addition, how the implant is placed along the bone and what size is chosen will influence how it will look after surgery.
Probably the biggest consideration in avoiding an unnatural cheek implant result is to not use too big of an implant. The cheek area is very aesthetically sensitive and trying to make too big of a change or use the implant to lift sagging cheek tissues can quickly make for a peculiar looking result. There are some good celebrity illustrations of this exact problem.
Dr. Barry Eppley
Indianapolis Indiana
Tags: cheek augmentation, cheek implant, dr barry eppley, indianapolis, natural cheek augmentation, plastic surgery
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Wednesday, October 6th, 2010
Q: Hi Dr. Eppley, I am interested in filling in my lower cheeks. They are sunken in and I have had multiple fillers from Radiesse, Juvederm etc for years. I am tired of it looking really good for 2 weeks due to swelling and then having it all disappear and look the same within the month. Do you ever do a tissue fill on the lower cheeks? I had one doctor do filler one time on the upper cheeks and I hated it. I looked like cat woman and I don’t like that look. I just want to fill in the bottom cheeks. I’m afraid to put in an implant because of the risk of crooked smiling. What do you suggest?
A: The area below the cheeks is known as the submalar triangle which extends from below the cheekbone down (in an upside down triangle) to below the side of the mouth. It is important to appreciate that this area is not supported by underlying bone. This is why anyone with a thin face or fat loss will show an indentation in this area and create a ‘gaunt’ look. This also means that there is no type of a bone-based facial implant providing any fullness to this area.
While synthetic injectable fillers will produce some temporary fullness, they are not a long-term solution to this area of soft tissue facial deficiency. The next logical approach is that of fat injections. While they offer at least the potential for some long-term retention, they are also plagued by potential resorption. I have mixed these fat injections with PRP (platelet-rich plasma) for facial injections and feel that this combination does offer better results. But the risk of near to complete resorption still exists. No one can predict how well fat injections will persist in any particular patient.
The remaining good alternative is that of dermal grafts. Using allogeneic dermal grafts, they can be put it in sheets and layers. They can nicely built up an area and are very soft. They are human collagen which will eventually be replaced by your own tissue. They can be put in through a limited facelift incision. Their long-term volume retention is much more assured than fat injections.
Dr. Barry Eppley
Indianapolis Indiana
Tags: cheek augmentation, dr barry eppley, facial dermal graft grafts, facial fat injections, indianapolis, plastic surgery, submalar augmentation
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Wednesday, October 6th, 2010
Q: I am 18 years old and cheek enhancement seems to have caught my interest. I’ve been rolling the thought of having a procedure in my head for quite some time now, so here I am asking for information. People say there is nothing wrong with my face but what I want is more defined cheekbones, like the male model look. There is this heart shape the cheeks do along with the jaw angle if you understand what I mean. What effects might the procedure have on my face in a long term period of time? I mean, when I get to 50, will there be any undesirable changes on my face? Thank you for your time. I look forward to receiving an answer from you.
A: High cheek bones are a frequent aesthetic desire. In a male the triangular effect of prominent cheeks, chin and jaw angles makes for that chiseled or angular face look. That particular male facial look is certainly one that is evident in many male models in magazines and advertisements.
While strong cheek bones may be desireable, they are not achieveable in every male face. While cheek implants can make the cheek area bigger, that doesn’t necessarily mean that effect makes for a more sculpted facial look. One has to look at the other facial features and the overall facial shape to see if cheek augmentation offers an aesthetic improvement. If cheek implants are put in just any face, some of those faces will just look like they have big or puffy cheeks and may not become more angular.
One positive long-term effect that cheek implants do is help maintain cheek tissues from sliding off the bone, so to speak, with age. In fact, they are occasionally placed in older patients for a midface rejuvenative effect to help lift sagging cheek tissues. Unfortunately, when done to an extreme, they can make the older face look odd or have an ‘apple cheek’ effect. There are numerous famous male celebrities that have this look.
Dr. Barry Eppley
Indianapolis Indiana
Tags: cheek augmentation, cheek implants, dr barry eppley, indianapolis, plastic surgery
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Thursday, September 30th, 2010
Q : I am interested in cheek implants but am not looking for a drastic change, just enhancement. I want to look better but have people not be able to tell what is different. I have a few questions. What is the recovery time from work and physical activity (running and cross training/weight lifting)? Are the implants inserted from the mouth and fixed to the jaw? Do cheek implants inhibit ability to smile? Approximately what % of patients are happy with the cheek implant procedure?
A: Cheek implants are done as a simple 1 hour outpatient procedure. They are inserted through the mouth and secured to the bone with a screw. There are no restrictions of any kind after surgery. While you will have some cheek swelling (but no bruising), there is nothing you can do from an activity standpoint that will hurt the implant or their position on the bone. One can eat and drink right after surgery. Pain is very minimal although usually there will be some temporary numbness of the cheek skin and a little bit of the upper lip. Cheek implants will not change your ability to smile or how your smile will look. Initially, your smile will feel a little stiff but that is due to the swelling. The vast majority of patients who receive cheek implants are happy but I also feel that it is the one facial implant that undergoes higher revision rates than all others due to inexperience in placing them, size and position selection, and style of implant used. It is a simple procedure to do but there is definitely an artistic flair to doing them well.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek augmentation, cheek implants, dr barry eppley, indianapolis, plastic surgery
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Thursday, June 24th, 2010
Q: I recently had cheek implants but now one side of my face has hollowed out and both sides of my mouth have developed drooping pouches of tissue . It looks very uneven and has distressed me greatly. I would like your opinion about this.
A: This is certainly a very unusual type of mouth result from cheek augmentation. The reason it is unusual is that cheek implants add volume to an otherwise prominent facial bone area. If anything it may cause a very mild cheek tissue lifting effect but not dropping of tissues as you state around your mouth. Early after surgery, in the first few weeks or month, one could have swelling and some bruising which drifts downward along the mouth and even into the neck. But if this is would not be the case more than a month after surgery. If other facial procedures were done at the same time, which would be common, then this could still be residual swelling which may yet go away.
Uneveness of cheek implants, however, is not rare and is probably the number one complication of cheek augmentation. It is more difficult than it looks to place cheek implants in the identical position on both sides of the face. The thickness of the cheek tissues do not make it easy to see minor differences in position during the actual surgery. I would wait at least three months after surgery to let everything settle before making a final judgment about cheek symmetry.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek augmentation, cheek implants, dr barry eppley, indianapolis, plastic surgery
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