What Is The Best Way To Determine My Cheek Implant Replacement Size?

Q: Dr. Eppley, I am interested in cheek implant revision surgery. I had cheek implants several years ago but because the implants did not provide me with the volume enhancement I wanted, I subsequently had fillers in both the malar area on the edge of the implant and in the submalar area right under the implant. Although I was satisfied of the combined effect I experienced twice manifestation of infection on one of the implants which has been addressed both times by antibiotics but I understand it is likely to come back (if biofilm has been created). So I would like to inquire about removing existing and replacing them with new ones that also provide the desired volume reducing the need for fillers.

A:While you did not state the exact style and size of the indwelling cheek implants they are clearly of the submalar variety of which there is a style 1 and 2. Also what is more unknown is where on the bone the implants actually are. Just because it is sitting a certain way on the model example does not mean how it is actually placed that way on the bone underneath it.

While the first cheek implants were a ‘best guess’ approach to get a desired result that should not be how you approach it the 2nd time. If you don’t know precisely the cause and effect relationship between implant details (style, sise and placement) and the effect it would just be guessing again the 2nd time. The point is I don’t consider implant replacements without a 3D CT scan so this information is clearly known. With that information then I can decide is there a better standard cheek implant that will work or do we have to go the custom design process to make it work.

Dr. Barry Eppley

World-Renowned Plastic Surgeon