Q: Dr. Eppley, I am a healthy 51 years old man and underwent a cheek implant procedure 15 years ago. The surgeon used Implantech´s Flowers Tear Trough implants, I am almost certain it was the size FTT-L Large (4.8 X 2.6 X 0.5 cm). He also suggested two nasolabial fold implants (those are quite small and he made them himself) and I accepted.
The problem is that, even though I have looked reasonably well up until now, the cheek implants where misplaced from the beginning. The right cheek implant is too high, tilted and very close to the eye and the left implant too low.
The nasolabial fold implants are also misplaced (they were inserted through my nose, and I think it was the nasolabial implants that made recovery quite difficult due to extreme and swelling that lasted very a very long time). Anyway, those implants go pretty much unnoticed and I only found out about their misplacement when I had a 3D face scan done recently.
I am in good shape, exercise, don’t drink or smoke, no heart or any other major issues whatsoever and have a normal build with about 20% of body fat. I lost a lot of weight – 25 pounds, from 185 to 165 pounds, thus becoming quite skinny – a few years ago and I started feeling some pain in the cheeks. I don’t know whether it was the cause, but when I regained my weight, the pain disappeared. I thought that the loss of fat in my face was the cause.
Today I look younger than my real age, and I my cheeks look fairly good, but I fear that as I age, the asymmetry will become more apparent. I was very interested on the idea of having customized implants that fit perfectly the shape of my cheeks and therefore will look natural no matter how thin my skin becomes in the future (or that’s what I guess).
I know that over the years, tissue grow around the implants and it becomes more difficult to replace them, so I don’t know how feasible my case would be or if you’ve had similar cases that wanted their implants replaced after so long.
Finally, I wonder whether having implants already in place would make more difficult to measure the cheeks and create new custom implants or if that fact is irrelevant to it.
Also, I would like to know what the steps would be. Could they be extracted and replaced in the same procedure?
A: Thank you for your inquiry and dealing your facial implant history and current concerns. In answer to your questions on your cheek implants:
1) Indwelling cheek implants do not make the surgery any more difficult regardless of the natural scar tissue which develops around them.
2) Indwelling cheek implants do not interfere sth designing custom ones as the existing implants are digitally removed. Actually they help in the design of the new ones since one can see where the old ones are and what they look like. When you know what doesn’t work well, it helps in making new implants designs to be better.
3) Cheek implant removal and replacement is always done at the same time.
If you have a current 3D CT scan please send me the actual disc as that is what is needed to make the new cheek implants.
Dr. Barry Eppley