Does A Cheek-Arch Style Implant Need An Ear Incision To Place It?

Q: Dr. Eppley, I am a trans male and I’m looking to get some facial implants to really masculinize my face. I am most interested in your custom cheek implants that I saw on your Instagram.

I noticed that you tend to design them differently. You make them much longer such that they extend all the way back close to the ear along the zygomatic arch. 

Do you have to make an incision over by the ear and an incision inside the mouth to insert these?… I see in the pic attached that the man has an incision along his ear 

 Also, I’ve read about some people on Real Self who can’t smile the same after getting cheek implants… Have you seen this ever in your practice? What are the odds of this happening?

A:Thank you for your inquiry. Many patient’s today wants a more contemporary model-like cheek implant result which comes from extended arch style designs. Provided they do not include a significant infraorbital extension they are placed through an intraoral approach. There is NEVER a need for an external ear incision with their placement. What you are seeing in that picture is a patient who also had a facelift procedure which has nothing to do with the insertion of the extended cheek-arch implant.

Like any intraoral approach to the maxilla or cheek there can be some temporary stiffness to the smile from the swelling but this is a self-resolving issue in the recovery process. I have never had a patient who has had any long-term issues in that regard.

Dr. Barry Eppley

Indianapolis, Indiana