Q: Dr. Eppley, Thank you for getting back to me so quickly in regards to my cheek implant removals.This has been such a nightmare and I just want to let you know how appreciative I am of your time. I had small malar/submalar implants put in one year ago. In hindsight I did not need the implants. I felt the implants were sharp and didn’t go with my soft delicate features. I waited for six months and then had them removed.
Now I have a whole new set of problems. I now have stretched out skin and sagging nasiolabial folds ( I think it’s my cheek collapsed) that are making me look much older and less beautiful than I am. I have attached a photo of me before and after removal so you can see what’s going on. I am considering having implants put back into my face as one option. Please let me know if you have any thoughts and or suggestions. I read your article about cheek suspension in situations similar to mine and I am hoping you may be able to help me.
A: Thank you for sharing your story of cheek implants and subsequent cheek implant removals. The sequelae from their removal is common and makes biologic sense since the implants disinsert the bony attachments of the overlying cheek soft tissues. Once the implants are removed, the overlying cheek tissues slide downward creating the effects you now see. Given that it has been six months since your cheek implant removals, you now have a good feel of how you look and whether you can live with the tissue changes.
Improving the fallen cheeks comes down to three options; 1) put back in new cheek implants, 2 ) do fat injections instead of cheek implants or 3) perform cheek resuspension. All three cheek restoration approaches have their advantages and disadvantages. The easiest is volume restoration through either new cheek implants or fat injections. Cheek implants would be more effective than fat injections for a variety of reasons. Cheek resuspension is always more appealing as it directly treats the actual problem but it is more unpredictable and is best done through a lower eyelid incision. Given your young age and what you do professionally, I would be hesitant about any external incisions on you no matter how well they may heal. Intraoral cheek suspension avoids this external scar concern but is far more challenging to do. The Endotine cheek/midface lift is one device that helps successfully execute the cheeklift procedure.
Dr. Barry Eppley