Posts Tagged ‘cheek implants’
Thursday, January 5th, 2012
Q: Dr. Eppley, I had my buccal fat pads removed nearly fifteen years ago at age 31 for some facial sculpting. Now that I am older, I look completely different. My face is very flat and not as attractive. What can I do to look like before? What are my choices for making my face now a little fuller?
A: As you have aged, your face likely has lost overall fat and the prior removal of the buccal fat pads has only accentuated this natural fat involution process. There are several options available to consider for facial volume restoration. The first approach is fat injections which focuses on replacing like with like. The only question is how much fat will survive after transplantation. This is an overall facial volume approach. The next approach is focal or spot treatment, just adding volume to the buccal or submalar area. This could dbe done with either submalar cheek implants or injectable fillers. The real value of injectable fillers in your case, in my opinion, is to be an initial test to determine if augmentation of this area is what you are looking for. It serves as a test to determine if more formal augmentation (implant) is worthwhile.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, dr barry eppley, fat injections, indianapolis, injectable fillers
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Wednesday, January 4th, 2012
Q: Dr. Eppley, my cheeks are very low and I would like them to be higher. When I pull upwards on them, my face looks better. That also helps soften the lines around my mouth. Will cheek implants create this effect or so I need some form of a facelift to get that look?
A:The question you are asking is an important one because there are clear differences between what cheek implants and a cheek lift achieve. Cheek implants are about creating a bony highlight for improved facial contours purposes. While there may be some cheek lifting effect, it will be relatively minor and one should not think of cheek implants as a soft tissue lifting method. (even though it can complement cheek or midface lifting surgery) A cheek lift is about lifting and resuspending sagging soft tissues that have fallen off of the cheek bone. This does create an effect sometimes similar to a cheek implant but it is more similar to what most patients thinik that a ‘facelift’ does in that area. This will help soften the nasolabial folds because it is pulling upward the soft tissues that lie above it. Based on your description, I suspect you would benefit more by a cheek lift than cheek implants. Whether that is a worthwhile surgery for you depends on numerous factors including your age, your cheek bone and lower eyelid anatomy and how much malar soft tissue ptosis you have.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, cheek lift, dr barry eppley, indianapolis
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Tuesday, January 3rd, 2012
Q: Dr. Eppley, I want cheek implants to help balance out my face. I have a strong jawline but no cheekbone definition whatsoever. I think that some type of a cheek implant would help balance out my face a bit more. However, I don’t want the implants on the apples of my cheeks but just on the top of my cheekbones to give me a more defined face. Is this possible? I’ve seen some awful examples of cheek implants where the apples of the cheeks have ended up looking way too large for the face they were on.
A: Choosing the placement and size of cheek implants is critically important in obtaining an improved but natural looking result. It would be essential to know exactly what part of the cheek you want augmented and a feel for how much volume you like. If in doubt, you should first try an injectable filler to get the exact location identified and make sure you like the result. The cheek area is one of the aesthetically sensitive facial areas and quite frequently poor results happen because of improper implant style and/or size selection. Cheek implants are a good example where a little volume goes a long way.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, dr barry eppley, indianapolis
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Friday, November 4th, 2011
Q: Dr. Eppley, I am thinking that I need something to make my face look better. I realize that I am young to be thinking about surgery, but I’ve never liked the way I looked. I thought maybe cheek implants might help, but I was wondering if you had any other suggestions of how I could make myself look better.
A: In looking at your pictures, I can see that you have some mild cheek flattening or hypoplasia. Higher cheekbones may be an accent to your facial appearance. Should you be so motivated, I would suggest you initially pursue injectable fillers for cheek augmentation. This would be a good temporary test to determine if the placement of permanent cheek implants would be aesthetically beneficial.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, dr barry eppley
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Wednesday, October 5th, 2011
Q: Dr. Eppley, I would like to start by saying your website and blog have been so helpful as both a research tool and making me feel so much more comfortable in approaching this issue. It is one of the few sources I have found that really takes the time to properly explain things, that most people in plastic surgery don’t understand. I would like to have more balanced facial features and to improve my asymmetries to improve my facial appearance. I feel that I have a long lower face and chin compared to my forehead, which is very low and slopping. I can’t wear hats and have to spike up my hair all the time so I don’t get teased. I recently lost a lot of weight and with it my cheeks, with used to be very full. But I guess what bothers me the most is my nose – I have a deviated septum which makes me look crooked and my nose is very romanesque in appearance. I think that a rhinoplasty and cheek augmentation would help me best but I’m open to suggestions. I just want to be the most attractive me I can be. From my photos can cosmetic surgery help me?
A: Facial symmetry and proportion are the two most important components of facial attractiveness. In looking at your photos, I would agree that the deviated and dorsal convexity of the nose combined with flat cheeks are the two main areas to try and improve. I would propose a rhinoplasty whose objectives are to straighten the nose in the frontal view and bring down the dorsal line to one that is straight between the frontal-nasal junction and the nasal tip. The tip could also tolerate a bit of thinning as well. For your cheeks, anatomical style cheek implants secured high up along the flat malar prominence will bring some highlights to your midface and more angularity to your face.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, dr barry eppley, indianapolis, rhinoplasty
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Wednesday, September 28th, 2011
Q: Dr. Eppley, I have lost a lot of the fat in my face particularly in the cheeks which has left them very hollow and sunken in. The area below my cheeks looks too full because it is indented above it. I havhe been told that fat injections would be the way to go even though fat transfer may not always stay. I know that cheek implants are permanent becuase they can not be absorbed. But I didn’t know of they come big enough to fill out the entire depressed cheek area. What sizes do they come in and do you think they are big enough to fill out the whole cheek area?
A:Your concept of considering cheek implants for helping restore facial volume loss is only partially correct. Cheek implants are not a substitute for fat injections when it comes to facial fat volume loss. The submalar style of cheek implant can help fill out the buccal area of the cheek (right below the cheekbone) but this represents only part of a larger surface area of the cheek and surrounding tissues which makeup the gaunt or skeletal facial look. Therefore, the use of this type of cheek implant may be a companion strategy with fat injections but is not a stand alone treatment for refilling out the deflated or fat-depleted face. Fat injections are more versatile because they can be placed anywhere. Cheek implants, even the submalar style, can not go very far from the edges of the bone and are more limited as to the facial area that they can cover.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, dr barry eppley, facial fat loss, fat injections, indianapolis, submalar facial implants
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Sunday, September 25th, 2011
Q: Dr. Eppley, I want your advise on getting suitable cheek implants. I currently have a Medpor midface contour implant. They were placed six months ago. My implants were placed unmodified. Although I have achieved a decent level of midface augmentation, I feel the implant is too large, surface area wise. It is too close to my eyes and is also too low and close to the top of my teeth. I also have visible edges on both the left and right side near my eyes.I did previously have a Lefort 1 osteotomy for my bad bite in the past but the central part of my face wasn’t really improved. What I was looking for in cheek implants was something to improve my midface. The current implants have alleviated midface flatness but I do still feel I look at bit gaunt but less so. However they are just too big, so looking for opinion of porex alternatives which might be appropriate. I was looking at either RZ 5m, or the 4mm extended malar, basically something to emulate the middle third or so of my current implant. I have attached pictures for you to see my face and what my current implants have done.
A: What you are showing is the problems with stock midfacial/cheek implants which are now, by your own illustrations, demonstrating that their shape is not adequate in multiple dimensions. This leaves you with three implant options:
1) Modify your existing indwelling implants by tapering the bothersome edges and adding/removing the areas to create better convexity.
2) Remove and replace your existing implants with new implants that would likely need a combination of infraorbital rim and cheek implants. The medpor RZ4 or the 4mm extended malar are reasonable options but they will need intraoperative modifications.
3) Remove your existing implants and replace with custom-made implants that are designed off of your own skull model.
While all of these are possible, they each have their own advanatages and disadvantages. Modifiying what you have in, while seemingly simple and easy, will not likely make a significant or the desired changes that you want. (but it is always worth a try) Replacing them with new stock implants I suspect will put you in the same position you are now, better in some areas but inadequate in others. There simply are not stock implants that can fully meet your aesthetic goals. Custom-designed cheek/midface implants are the most likely to really meet all of your aesthetic midfacial goals as all of the planning and adjustments of them are thought out before surgery. The only downside is the increased cost to do so.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, custom cheek implants, dr barry eppley, indianapolis, midfacial implants
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Sunday, September 25th, 2011
Q: Dr. Eppley, I’m interested in cheek implants and a few other things that might be needed depending on your recommendation. My goal is to have a defined cheek/jaw line like some male model pictures that I have attached. I will get the buccal fat removed also if that is required. The 1st model model might have the cheek implants because the cheek area is not as pronounced as in the 2nd picture. I have attached pictures of myself from different angles so you can see the shape of my face. I look forward to your recommendations.
A: I have done an analysis on the photos that you have sent. The frontal photo is of excellent quality, the side view is not good quality but useable. I have also looked at the model photos that you have shown, and while they illustrate a facial shape goal, I hope you realize you can never look quite like them as you have a completely different facial shape.
Where I think your face can be improved is in multiple areas including vertical chin lengthening with some horizontal advancement (chin osteotomy), cheek augmentation with implants, buccal lipectomies, rhinoplasty with tip thinning and nostril narrowing and earlobe reductions. I have attached some computer imaging to show you a realistic potential outcome.
With your thick skin and existing facial shape, there are limits as to what can be achieved. I thinik this is the best approach to obtain some increased facial angularity.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, dr barry eppley, indianapolis
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Monday, August 1st, 2011
Q: Dr. Eppley I am 34 years old and in the past several years I have noticed quite a lot of sagging in my mid and lower face along with volume loss. Cheeks have gravitated downward, neck sagging and my eyes have hollows under and around them. I see much of the same in my mother. I have researched many plastic surgeons this past year and have heard only great things about you online! I am most concerned with sagging in my lower face, neck and around cheeks. I also would maybe like to add some volume to lips especially from a profile view. And one more thing, my ear lobes tore several years ago from scabbing due to hypersensitivity to earrings so I would like to have ear lobes repaired as well.
A: I have taken a careful look at the pictures you have sent me. As you know you are fairly young for any major procedures and you really don’t need anything too drastic. But I can see your concerns about having an overall tired appearance. There are several things I might consider for some structural improvement. These would be the following: small cheek implants to lift the midface and fill out some hollowing, small chin implant for more chin projection and to improve the jawline, and liposuction of the jowl and neck for a little contouring and skin tightening. I think if you can just ‘slenderize’ your face a bit and give it some more structure or angularity, it will look more youthful and rested. You most certainly don’t need anything done around your eye area.
As you know, you already have excellent lips with good vermilion show so increasing their size is a matter of adding some more volume. This could be done with fat injections as you can take advantage of a surgical opportunity since this is not a traditional office procedure. Obviously the earlobe repair can be done at the same time with any of the aforementioned procedures.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, chin implants, dr barry eppley, indianapolis, structural facial surgery
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Thursday, July 21st, 2011
Q: Dear Dr. Eppley, I’m writing to you in regards to plastic surgery options. You were recommended to me as a highly qualified professional. I’m a 24 year old and I wish to transform my face for it to be more balanced and more aesthetic in general. Enclosed please find pictures for my face from various angles and a picture that I did in Photoshop which outlines how I would like my face to look. Is this realistic? Here are things that concern me by order of importance:
1) Jaw/chin is too prominent, protruding and simply too large. I would like bit smaller jaw and chin, making my face look more compact, yet remaining sharp and angular.
2) Cheek bones. As you see, mine are quite flat. Cheek implants would probably benefit here.
3)Nosejob – make my nose more prominent and fill the radix.
4) Eyebrow transplant
I would like to know my facial surgery options. This is very important for me so I would kindly ask you to provide me with a professional and honest opinion.
Thank you in advance.
A: Thank you for sending your pictures. As you have already done a nice job with Photoshop on your face, and I think all those changes are both possible and realistic, my task is to comment on how to accomplish those potential changes.
The reduction in the chin is of a horizontal nature. There are two ways to accomplish that task, either a setback genioplasty or an open submental burring reduction. I would feel more confident with the open submental approach so there are no irregular bony edges and an excess soft tissues can be excised and tightened. That is done from an under the chin (submental) incision. The other alternative is to do a setback chin osteotomy with the possible need of a submental tuck-up later is needed.
I agree about the need for cheek enhancement and stronger cheek bones using implants would be beneficial, particularly to balance out the stronger chin. (a ying and yang effect if you will)
Your ‘deficient’ nose is part of the overall flatter or less well developed midface. A dorsal augmentation rhinoplasty, in combination with cheek augmentation, would put the middle third of the face in better balance with your jawline. The real debate here is what material tio use to build-up the nose. My prerference would be your own cartilage.
Eyebrow hair transplants are the only other choice besides tattooing for improving congenitally deficient eyebrow hair density.
Dr. Barry Eppley
Indianapolis, Indiana
Tags: cheek implants, chin reduction augmentation rhinoplasty, eyebrow transplants, facial restructuring
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