Cheek Implant Replacements

Q: Dr. Eppley, I am interested in cheek implant replacements. My current cheek implants are a medium combination submalar and malar midface implant. It’s opaque, blue and a rubbery material. The side that is placed on the bone has small tentacle like projections. 

I’m not sure if it caused by improper placement, sizing, implant shape or a combination of both, but my smile is restricted compared to before I had the implants (as in I cannot smile as wide after getting the implants).  My surgeon insists that it’s due to my facial muscles and maybe I’m the small percentage whose facial muscles cannot glide easily over the implant (he’s also blamed it on the fact that I’ve had a child but my smile was completely normal after delivering my daughter), but I’m having difficulty believing that is the case.

In any case, I have attached a few images for you to review. The first two images are pre midface implants. The last two are after implants (one before I delivered my second child and one after). When I am thinner, the implants look to large and I have a hollow under   It in the cheek area.  When I have more weight, I just look completely overdone and the issue with my smile is exacerbated. The other surgeon said the weight from pregnancy would fill in the hollows but either way… to put it plainly… it looks like crap and everyone I know can tell I’ve had work done. Needless to say it’s been an unpleasant experiences and I just want to get it fixed.  

Let me know if any other info is needed on my end! Thanks!! 

A: What you describing is a Conform malar shell style of cheek implant. (a blue implant is the sizer not the actual implant) In reading your concerns the most likely explanation of your symptoms is that of implant size and/or style. It is very easy in the cheek to get implants that are too big. If they were too big when you were thinner that will not change and mag even be exacerbated with more weight in the face. Cheek implants are a great example of less is usually better. Benefits ma y one obtained by either downsizing them or changing to a smaller and different stye. ideally a 3D CT scan should be done to also check their position on the bone which may also be too anterior.

Dr. Barry Eppley

Indianapolis, Indiana