Should I Get Facial Implants Or Fat Injections For Facial Volume Enhancement?
Q: Dr. Eppley, I need help in figuring out the best way to enhance facial volume. I have hollowing under my eyes and would like a stronger jawline. I had cheek implants placed two years which have done great so am looking for similar impact on my other facial areas. But I’m not sure what the best way to accomplish this is using either facial implants, fat injections or injectable fillers.
A: When it comes to facial volume enhancement the surgical debate is always whether it should be done by fat injections or facial mplants. This is no different that the debate would have been about your previous cheek augmentation. There are advantages and disadvantages for either approach but that debate must be assessed more specifically for the facial area that one wants to enhance and whether it is composed of underlying bone, soft tissue or both.
The jawline is primarily supported by bone so any effective augmentation is almost always done by some form of implant placement. You would have to further define what jawline area to which you want changed to better answer what type of implant may best address it. This is identical to your cheeks which are usually most effectively done by implant because they are a bony supported area.
The under eye area is different than the jawline because it is a combined bone and soft tissue area. The lower end of the under eye area is the inferior orbital rim while most of the lower eyelid is soft tissue supported. This usually means that fat injections are needed as an implant only covers the very lower end of the under eye area and placing it requires a lower eyelid incision to do so. So fat injections, even though they are unpredictable, usually win out over any implant augmentation. Their ‘softness’ is kore appropriate for the under eye area than the jawline.
Dr. Barry Eppley