Do I Need Custom Cheek Implants?

Q: Dr. Eppley, here are picture of my cheeks. Two are obviously when I went for a consultation for implants, these are the highest profile ‘off the shelf’ implants & I would go with them if a custom option wasn’t available. Third pic is of natural cheek, you can see the flatness on the point, this is what I want corrected. BUT, the fourth pic shows the lumps that I have on my face (right side is narrower & harder than the left…..left hasn’t shown up in this pic). 

These lumps are why I am thinking custom implants would be best as can they be tailored around these lumps (which I am now thinking must be ligaments) in order to hide them, they do really bother me as people are always mentioning them, am I tired etc etc!

A:Thank you for sending your facial pictures. When it comes to cheek augmentation the first thing to determine is where is the zone of augmentation and how much augmentation does the patient prefer. Based on your picture my interpretation of your cheek flatness is in the attached imaging. I’ve looked at two different degrees of cheek augmentation in that area one of which is stronger than the other one. Based on the zone and cheek augmentation I would think standard implants as you have shown would be effective. The role of custom implant designs is used when; 1) the degree of facial augmentation  change is not achievable buy standard implants, 2)  there is significant asymmetry between the two cheek sides, 3)  there are adjoining facial areas that also desire augmentation such as the maxilla or orbit or4) standard implants have been used and they have proven to be unsatisfactory.

Dr. Barry Eppley

World-Renowned Plastic Surgeon