Do I Need Facial Implants Or Fat Grafting?
Q: Dr. Eppley, I have some questions about facial implants. I had a square chin implant and paranasal plus midface rim implants placed one month ago. I’m happy with the augmentation they’ve provided, but they haven’t exactly addressed the areas I really wanted augmented. I’m aware that there’s still quite a bit of swelling, but the parts of my face that were initially deficient now look worse in relation to my augmented mid-face and chin. Here are my questions:
1) It has been 4 weeks since I had these implants placed. Given your experience, what % of swelling is there still remaining?
2) The paranasal implants have given me mid-face volume, but the area that I really want augmented is the areas under the nose and above the upper lips. I’m looking to make that region more convex to obtain a ‘step off’ between the upper mouth and the mid-face. I’ve done a bit of research, and I suspect I may need premaxillary implants.
3) I had this weird issue of there being some kind of ‘jowl lines’ from my lower lips to the sides of my chin. The chin implant does seem to have exacerbated it, and I don’t think implants are going to address the issue. I’m not sure what has caused it, but the region below my lower lips appears to be more convex relative to the areas to the side of it, which is what gives the appearance of jowl lines.
Anyway, do you think that fat grafting to the perioral and upper chin region will address it? Further, if I’m getting fat grafting done, should I consider getting fat grafts placed in the premaxillary region too? Could you kindly give me your professional advice on my options to augment these areas?
A: At just four weeks after facial implant surgery, you probably have about 75% of facial swelling reduction. But the remaining 25% of facial swelling and soft tissue adaptation to the new facial contours will take several months to resolve.
Facial implants are generally designed to provide augmentation of facial skeletal areas that are flat or convex in nature. They are not effective for concave facial areas that are not supported by bone. Thus, premaxillary augmentation is best done by an implant while the jowl areas above the jawline are better augmented by fat injections.
Dr. Barry Eppley