Would Custom Cheek Implants Be A Good Place To Start For My Facial Feminization Surgery?

Q: Dr. Eppley, I am interested in facial feminization surgery of which I would like to start with cheek augmentation surgery first. Based on what I have seen of off the shelf cheek implants I know I would need custom cheek implants to achieve the midface look I am seeking. I have attached pictures and videos to show what I would like to achieve for my cheek augmentation.

A: Thank you for your inquiry, sending your picture and videos and very thoughtful commentary to your approach to facial feminization surgery. Choosing one or two procedures at a time is a very appropriate way to approach it because it makes you feel comfortable. Some prefer to dive into the pool so to speak while others wade in from the shallow end…it is all about what makes the patient feel comfortable.

You have made your cheek augmentation goals very clear and the only question is what is the best way to achieve them, meaning what I call a custom or semi-custom cheek implant approach. You have correctly surmised that no form of a standard cheek implant is going to achieve your goals. A custom cheek implant approach is when a 3D CT scan of the patients is used to create a very specific design. A semi-custom approach is when I go to my library of cheek implant designs (other patient’s custom designs) and print off one of them that I feel has a good chance to achieve your goals. The cheekbone and arch is not structurally that complex so if the patient so chooses that can be a good option. I would also agree that a buccal lipectomy with the cheek implant is a good complementary procedure as the two work synergistically to create the most significant change which is what you appear to be seeking. Whether one combines that with a rhinoplasty is merely a matter of opportunistic choice.

I have attached a model example of what you are seeking probably a bit more than that) and an example of the cheek implant style that it takes to achieve it.

Dr. Barry Eppley

Indianapolis, Indiana