Q: Dr. Eppley, I am interested in getting a cheek implant. I was in a car accident ten years ago and had reconstructive surgery on right side of face. You can see that my fave is fuller along the jawline and lacking fullness on the apple of my cheek. I’ve had fillers for years to temporarily fix the problem area but I hate it. I’m ready for a permanent fix so I can feel beautiful. You can see in my attached pictures my facial asymmetry problem.
A:Thank you for sending your pictures. You have the classic cheek deformity that often occurs after a zygomatico-maxillary (cheekbone) fracture where the projection of the cheek is ultimately lost from inward translocation of the arched cheek bone complex. Given your naturally very high cheekbones (as seen on your left side) it would be easy for such a fracture and even its repair to match the naturally high cheekbone projection that you have. You are correct in that there is a simple fix to that concern by placing a cheek implant on top of the most depressed portion of the bone. This is done through a small incision inside the mouth.The key is both the proper cheek implant shape and size.
Dr. Barry Eppley
Q: I have a fracture in my right cheek bone from a fall. There is a dent in bone. Is there anything that could be done to fix it. I’d like to send a picture of me to you.
A: Thank you for sending your picture. What it shows is the sequelae of a a cheek or zygomatic infracture. When the cheek bone is struck with enough force it will fracture the ‘legs’ of bone which support it. When the cheek bone loses this support, it will always fall down and inward impacting into the maxillary sinus. This is known as a rotation fracture. When this happens the prominence of the cheek is lost, causing an indentation of the cheek. That indentation will appear just below and to the side of the eye. It is the prominence of the cheekbone which is lost.
Secondary of uncomplicated cheek fractures can take two approaches depending upon the degree of displacement and if there are other associated symptoms. Rebreaking the bone (cheek osteotomy) is only indicated when the amount of displacement is severe and there may be some nerve pain or numbness and alteration of the corner of the eye. If the indentation is the only problem, however, a cheek implant will usually suffice.
Through an intraoral (inside the mouth) incision, a cheek implant can be easily placed. It is important to have the right shape of cheek implant and that it is accurately positioned over the loss of prominence for the best correction.
Dr. Barry Eppley