Q: I am interested in rhinoplasty and cheek implants and have had a consultation done which included computer imaging. The profile images show a nice improvement but in the front view I can see very little change around the cheeks and eyes. Will the actual surgery fill out these areas nicer than what I see in the imaging? What about the nasolabial folds, don’t they also diminish with cheek implants? Do you think larger cheek implants are better for me? (I heard small ones are unnoticeable)
A: While I have no idea as to the quality of the computer imaging that was done, it is difficult to show much cheek improvement from a front view. Computer imaging works best on facial structures that are not overlapped or in profile. That is the problem in the cheek area, it is not a profile structure unless it is imaged in the oblique or three-quarter view. Most likely, cheek implants will produce a much better result than what those images show…particularly if the cheek implants are a size beyond the very smallest. You are correct in that small cheek implants in most patients ones can barely be seen or are very subtle.
Cheek implants may create some lessening of the nasolabial folds but it will not be substantial. That is not an intended or known effect from cheek implants. However, paranasal implants can make a bigger difference as they are placed right behind the nasolabial folds so they create more of a push outward, thus lessening the deepest upper portion of the nasolabial fold.
Dr. Barry Eppley
Q: Dr.Eppley, will you look at patients that had cheek implants performed by another surgeon? The surgery was performed a month ago and they are asymmetrical and one side is more swollen then the other. They don’t look right. I would like them revised or removed.
A: Thank you for your inquiry. The first thing to realize about cheek implants is that the swelling between the two sides is never exactly symmetrical. Even though you do exactly the same thing to both sides, they will have differential amounts of swelling. Secondly, it really takes almost three months to see the final results from the procedure. It takes this long to have almost all of the swelling gone and to see if true cheek implant asymmetry exists. Since you are only one month from surgery (which does seem like forever when you are the patient), it is too early in my opinion to yet assume that the cheek implant placements have been asymmetrical. That being said, I would be happy to assist you. Please send me some pictures and any information about your surgery (when, type of implants if you know etc) that you know. Let us assume that after three months, this cheek asymmetry persists. Since there is asymmetry, I am assuming that there is one good side and one unhappy asymmetric side. That raises the question about whether the off side should be adjusted to better symmetry, changing the styles and position of the implants on the cheeks (there was a good reason you have it done to begin with) or simply having them removed altogether. At that point, we can delve into what your original objectives were for getting the cheek implants and see if that effort can be salvaged.
Dr. Barry Eppley