What Type of Cheek Implants Do I Need For High Projection Near The Zygomatic Arch?
Q: Dr. Eppley, I’m 21 years old and I have average sized cheekbones. I’ve always dreamed of having very prominent and chiseled cheekbones, such as those of Mads Mikkelsen (even though I’m a girl) that have more projection on the outer corners of the zygomatic bone as opposed to the classic apples in the area below the eyes. I would like to augment a good part of the bone, yet pay much more attention to the area adjacent to the zygomatic arch. Many people would recommend me to aim at a natural and light outcome, but I want a very noticeable difference. I’m also a bit confused about the procedures. So far I’ve read a fair few articles regarding PMMA bone cement as well as Kryptonite and something about Medpor, still I have no clues whatsoever which one would suit my needs best. I would like something that is permanent, that endures time, that is at least as strong as the bone itself and that doesn’t get loose. As to the volume to be added, would it at all possible to have a 7mm or over projection.
A: When it comes to cheek augmentation, it is very important in any patient that the correct zone (s) of the cheek or zygomatic bone is augmented or highlighted. You have described exactly where you want the maximal augmentation to be done (posterior malar) as opposed to anteriior submalar which, as you have corrected stated, is the usual highlight augmentation zone for a female. That is is very helpful as then the correct cheek implant style can be chosen.
When it comes to cheek implant augmentatation material, no form of bone cement would be appropriate. What is used are preformed implants made of either silicone or Medpor material. Both are permanent materials that will never degrade or change shape and when fixed to the bone will be just as strong as the bone underneath it. Their ability to stay in place is more about how the pocket is made and how they are secured than it is about the material. There are advanatges and disadvantages to either solid silicone elastomer ot medpor, but my preference is for silicone as there are many more styles and size options and it is far easier to revise should that ever need to be done.
As for size of the cheek implant, 7mms would be a very strong change and may or may not be too much. Such thickness numbers may seem small but when it comes to putting an implant on your face, it can easily end up being much larger than one would have initually predicted. When it comes to facial implants, a slightly too small change is always better than one that is too big…as that will always lead to revisional surgery.
Dr. Barry Eppley