Custom Cheek Implants

Q: Dr. Eppley, I am interested in custom cheek implants. Last year I got a custom wrap around jaw implant which produced a nice flare towards the back part of the jaw.  I like the beefed up jaw, but now feel my cheekbones could be a little wider to balance my face out a bit. As a trial, I had the cheek area filler injected to try out the look (a total of 2 cc’s of Juvederm).  It was a step in the right direction, but I thought for the long term it might be better to go with implants (perhaps custom) and that I could get a little more projection than I got from the filler.  Do you think cheekbone implants might be a good idea and should I be concerned that the implants might show themselves through the skin down the road? I have attached a Photoshop rendering of me with larger cheekbones. What do you think?

Also Do you think a buccal fat removal procedure would help with the excess jowl tissue?

A: It is not rare that after a jawline implant, where the lower face has gotten wider, that one notices that other parts of the face are out of balance a bit. As a general aesthetic rule, the width of the jaw angles should not be greater than the width of the cheeks/zygomatic arches. This has clearly happened in you and is the genesis of your inquiry. You have proven by both injectable filler and computer imaging that cheek augmentation would be beneficial. To get the best fit to the bone and have the least risk of implant show, custom cheek implants would be preferred. This is particularly true in what you are showing in your imaging as this is a high cheek look. Most standard cheek implants are made for women and they highlight the lower apple cheek area primarily.

Jowling will not be improved by a buccal lipectomy. The buccal fat pad is situated much higher than the jowls. Jowling has to be treated by either direct liposuction or smoothing out the jawline from a small lift.

Dr. Barry Eppley
Indianapolis, Indiana