Does Cheek Implant Removal Cause Sagging?

Q: Dr. Eppley, I had combination malar submalar implants placed a year ago, but they were too big and I had them removed. I later decided to go with malar implants only, but they got infected and I had to remove them too. I guess you can say that I haven’t had the best of luck with these implants.

Anyway, what I’ve noticed is that there seems to be some sagging in the mid-face from the cheek implant removal, and I seem to have deeper nasolabial folds and some droopiness at the corners of my eyes too. I’m not too happy with this, and would like it fixed.

Would it be possible to explain to me what my options are? Are there any minimally invasive lifting procedures that can be done? I’m still young (mid-20s), so I would preferably like to avoid anything too extensive or invasive.

A: With cheeks implant removal of any style and size, tissue sag is inevitable due to loss of anchoring attachments of the overlying cheek tissues to the zygomatic bone. The only potentially effective treatment would be cheek soft tissue resuspension. There are multiple ways that cheek resuspension can be done from using intraoral, lower eyelid and temporal suspension points of anchorage. One can debate whether any of these techniques are less invasive or extensive than the other, but I would not make much of a distinction between them. It can also be debated as to which of these cheek resuspension techniques is more effective than the other. But that is probably more surgeon dependent than technique dependent per se. Lastly whether they can create the more complete improvement that you seek (midface sagging, nasolabial fold reduction and corner of eye droopiness correction) is asking a lot of them.

Dr. Barry Eppley

Indianapolis, Indiana