Q: Dr. Eppley, I am a 24 year-old man who is interested in getting cheek implants for a more chiseled look. I guess some call it the male model look. Whatever it is called, I just want higher and prominent cheekbones. What are the risks of cheek implant surgery? I know there is the risk of infection but the onke that I am most concerned about is nerve damage. How likely is the risk of paralysis or nerve damage?
A: Like all facial implants, there are some general risks such as infection but each implantation site has its own unique set of considerations. For cheek implants, the most common aesthetic risks are asymmetry because they are usually done as a pair. While it seems easy to place two symmetrical implants, because one is doing the exact same thing on both sides, the results are not always perfectly symmetric however. The other aesthetic risk is obtaining the patient’s exact aesthetic result. The cheeks are a unique three-dimensional structure that defies an exact quantitative method to determine the amount of augmentation needed in all dimensions. The implant style selection and size is purely an art form with little exact science behind it. When you factor in the unique underlying bone structure of each patient’s face, it is easy to see why achieving the ‘male model look’ cheek augmentation result is not always easy or assured. When it comes to the risk of nerve injury, you are referring to the infraorbital nerve. This is a sensory (feeling) and not a motor (moving) nerve. So the risk is one of temporary vs permanent loss of feeling in the upper lip and side of the nose. Fortunately, the infraorbital nerve is big and easily visualized during surgery so the risk of cutting it is virtually zero, thus permanent loss of feeling is very unlikely. Most patients will have some temporary numbness due to exposing the nerve with traction on it but this is rarely ever permanent. The surgeon must be very careful during cheek implant placement to not have the implant impinge on the nerve as this is often a likely source of persistent nerve numbness and pain after surgery.
Dr. Barry Eppley