If I Have Facial Asmmetry Before Surgery with Cheek and Chin Implants Will It Be Better After Surgery?
Q: Dr. Eppley, I wanted to let you know that I have fillers in both cheeks. They are about a year old and about 1 syringe of Voluma was used. I do like the fillers and would like to replicate their effects with implants. As for my chin, I would like more projection and length to help add more balance to my face. I also mostly wanted the profile of my cheeks to taper down towards my chin. I would also like my chin to be more symmetrical.
My first major concern is about the longevity of the cheek and chin implants. I was wondering what techniques you use to make sure the implant does not shift at any point after the surgery.
I have also heard that cheek implants have a high infection rate. I was wondering what techniques you use to ensure the implants do not get infected at any point after the surgery.
Another concern of mine is how symmetrical my face will look after the surgery. I understand that there will still be some asymmetry no matter what. However, I was wondering how you ensure the implants will suit my face and look as proportionate as possible after the surgery.
Lastly, I was wondering if you can give me a price estimate for both surgeries done at the same time, including surgery fees and implant prices. Do you have any travel or hotel accommodations, as well?
Thank you again for getting back to me. I look forward to hearing from you.
A: Thank you for sending your pictures. In answer to your questions:
1) In addressing your aesthetic chin goals, a chin that needs both horizontal an vertical elongation is best done with a sliding genioplasty not an implant in most cases. (implants do not provide any significant vertical elongation effect) Although in looking at your pictures I do not see the need for much vertical elongation of your chin.
2) In addressing your aesthetic cheek goals, 1cc of filler per side is equal to a small or medium sized cheek implant. Since I don’t know what you looked like before, I can not say what style of cheek implant that filler is creating.
3) Any type of facial implant is composed of a permanent material that does not degrade, break down or ever need to be replaced due to loss of material integrity. Thus they have a lifetime duration.
4) I am not aware that cheek implants have a ‘high infection’ rate. That source of information is inaccurate. Their infection risk is no higher than any other facial implant.
5) Numerous intra- and postoperative strategies are done to reduce the risk of any facial implant infection. But no strategy can completely eliminate that risk…short of not having the surgery.
6) If you have known facial asymmetry then one can be assured that they will have facial asymmetry after the surgery. Placing implants that have the same size and shape on asymmetric facial bones is guaranteed to create ongoing postoperative facial asymmetry. The only question is how significant will that be. To answer that question it is best to get a 3D facial CT scan before surgery to assess how different the two sides of the face are and whether the use of standard or custom implants offers the best aesthetic outcome.
Dr. Barry Eppley