Q: Dr. Eppley, How long does it take for the tissues to shrink back down and stick to the bone after cheek implant removal? I had anatomical malar shell implants placed three months ago and then had them removed after being in for just six weeks. I think all of the swelling is now gone but my cheeks don’t look like they did before. I have more cheek sagging and my nasolabial folds are deeper than before. I thought the stretching caused by the cheek implants was reversible and would just shrink back down. What can be done now? I want my old cheeks back!
A: When undergoing any form of facial implants, it takes time to see the final results as the tissues settle down around the implant and you adapt to your new facial look. Removing your cheek implants just six weeks after having them placed may have been premature. One of the reasons you do not want to be quick about reversing facial implant surgery is because of tissue deformation. There is no guarantee that the tissues will return to their pre-implant state. In placing cheek implants, the tissues must be stripped off of the bone over a wide area to get the implants into proper position. This not only stretches the tissues (actually a relatively minor effect) but, more importantly, the tissue attachments to the bone is forever altered. It would be natural after implant removal that the cheek tissues can sag somewhat since these tissue attachments will not jump back up into their original position. Once can see that the bigger the implant and size, the more significant that this cheek sagging problem can be. With more cheek sagging, the deeper the nasolabial folds can be. Improvement would either require implant augmentation or some form of a cheek lift or resuspension.
Dr. Barry Eppley