Custom Cheek Implants

Q: Dr. Eppley, I am an Asian male interested in custom cheek implants. Is it possible through custom implants to add lateral projection to the zygomas? What would be the maximum lateral projection the implants could give? (Iam hoping for at least 1.5cm to each zygomatic, but 2cm each would be ideal). I am after a look of very prominent cheeks to go with a very prominent jawline (also through implants) similar to the guy in this picture (note his flanged and very prominent cheekbones) Thank you for your assistance.

A: When it comes to designing custom cheek implants, any size or dimensions of the implant can be done. In making these designs and in looking for an ‘extreme’ facial look, one only has to be vigilant of two issues. First, one must make sure that the size of the implant does not preclude a good and competent intramural soft tissue closure over them. The stretch on the cheek tissues in very large implants can theoretically cause such an issue which would be disastrous if wound breakdown occurs postoperatively. Fortunately the cheek soft tissues are fairly elastic and have a lot of give to them. Secondly, one must avoid making an implant that is too big and thus creating the need for revisional surgery. The actual site and thickness of a cheek implant to create the look you are desiring is probably less than what you think. I have placed cheek implants up to 1 cm in thickness on each side and it can be impressive as to how much change that creates. I would doubt that you need 1.5 cm to 2cms of width on each side to achieve that cheek augmentation look. Dimensions such as those does run the risk of oversizing and the potential need for a revisional surgery to downsize the implants.