Will Cheek Implants Have The Same Effect As Injectable Fat Grafting?

Q: Dr. Eppley, I had fat grafting to my cheeks and for the first six weeks I was really impressed how good it was looking and it added to my feminine look. But after 6 weeks most of the fat has gone away so I was thinking how can I make that permanent and i was thinking to do cheek implants. I have drawn the area and also send you another pic how i looked directly after the fat graft. So I don’t really want to widen my cheeks. I want more a layer that not makes my face so flat. Will that be possible? If yes I would also like to see those cheek implants before the operation.

A: Thank you for sending your pictures and illustrating your fat grafted areas. The areas you have outlined are not really ‘cheek implant’ areas but are infraorbital-maxillary midface areas. Even the most lateral part of your drawing is barely on the anterior cheek area. This is consistent with the general area of augmentation when patients want to pull their midface forward but not widen it and this is most commonly down with either hand carved ePTFE block implants or custom midface implants. (standard cheek implants do not have a good shape to use in tis area)

While you are correct in that implants offer a permanent solution to the unpredictable volume survival of fat injections, they also differ in the facial areas that ca be augmented. While fat grafts can be placed anywhere on the face, implants must largely occupy bone-based areas. Thus an implant augmentation can only cover the half or two-thirds of the outlines areas you have made. Anything below the horizontal lines I have drawn on your marked areas will not be able to be augmented by implants.

Dr. Barry Eppley

Indianapolis, Indiana