What Type Of Complications Can Occur With Getting Cheek Implants?

Q: I am interested in cheek implants and until now I have thought that this compared to other plastic surgery procedures would be a relatively simple procedure with a minimum of complication rate. Recently I have seen a scary video on Youtube that shows a patient who developed a bunch of complications a few weeks after this procedure. He isn´t able to smile on one side of his face. One implant moved the whole way down the cheekbone and the other implant developed some kind of air pocket between the cheekbone and implant.One of the implants got infected. This patient also mentioned in his video that the surgeon removed some bone of his cheekbones before he inserted the implants. I can imagine that you don´t like to comment on another surgeon´s work. Could you please tell me if these are complications that could have been easily avoided by a well trained surgeon?

A: You would be correct in assuming that I wouldn’t comment on any specifics about another surgeon’s work or results. That is not a protective maneuver for other surgeons but because many details of other patient’s surgeries and cases are not known to me and often how the information is presented may not be complete. There is also the old motto of ‘there are two sides to every story’.

But I can make some general comments about cheek implants and their potential outcomes and complications. I have never seen the type of complications from cheek augmentation that you have described. In my experience, the most common complications are aesthetic in nature. Asymmetry of cheek implant position or too large a size or incorrect implant style for the desired effect are more likely complications to be seen. These can be resolved by implant adjustment and/or replacement. Infection of the implant is also a potential complication but this is uncommon in my experience with cheek augmentation. I have done many cheek implants in combination with maxillary or LeFort osteotomies, where the implant sits directly over an open sinus cavity, and have yet to see an infectious outcome with its use in that ‘higher risk’ use. The best way to avoid many of these cheek implant problems is to secure them to the underlying bone with a screw and get a good two-layer soft tissue closure over them.

I have a hard time figuring out how any type of permanent facial nerve injury can occur from cheek augmentation as the terminal buccal branches of the facial nerve are well above the subperiosteal dissection used for the placement of the implants across the zygomatic bone surface.

Dr. Barry Eppley

Indianapolis, Indiana