FIRST QUARTER 2001, VOLUME 15, NO 1

Implants augment the midface and give definition and youth

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Implants augment the midface and give definition and youth

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Do you have a tired look? Perhaps you think you have never had the high cheek-bones associated with youth-fulness. Malar (cheek) augmentation uses implants to replace bony deficiency, to improve balance of facial features, or to reposition the sagging skin upward and outward to fill hollows and depressions.

Understanding cheek implants
One of the strongest characteristics of youth is fullness of the cheeks, indicating an abundance of healthy soft tissues and fat that is present beneath the skin. Also a sign of vitality, the cheekbones are responsible for defining the face, highlighting the eyes, and adding overall balance to your features. Not everyone can retain contour and fullness with age. Not everyone has prominent cheekbones.

Are cheek implants right for you? The most common indicators are:

  • underdeveloped cheek bone structure; and
  • loss of soft tissue and the fat pad (due to aging process).

When there is depletion of tissue and fat and minimal cheekbones, the skin sags, appears flattened or sunken, and may cause folds and wrinkles around the mouth.

Many physicians liken the implant to scaffolding because it holds up the collapsed soft tissues. The augmentation to this area simulates soft tissue and restores the youthful appearance of adequately padded skin at healthy levels of distention and elasticity – a necessary component of a youthful face.

Understanding the procedure
Malar augmentation is usually performed under local anesthesia with sedation. The procedure takes approximately 45 to 90 minutes and can be performed alone, or in combination with forehead, eyelid, facelift, nasal, or chin surgery. First, your surgeon will thoroughly cleanse the face with an antiseptic cleansing agent. Then an incision is made either inside the mouth – the more frequently used method – or below the lower eyelids. With the internal approach, the incision is made high above the gum line and a pocket is created over the bone.

How is the implant selected? Your surgeon will describe the material that the implant consists of; silastic is a solid, pliable silicone rubber that is frequently used. This silastic material has been tested for over 50 years and is used because of its consistency, flexibility, firmness, and resistance to infection. The size of the implant ranges from three to six millimeters. The shape is usually triangular. Each patient is evaluated for proper sizing of the implant that will provide the desired effect. Your surgeon may customize the shape of the implant by carving it to suit your unique structure.

After the incision, a pocket is created in the patient’s cheek. An implant sizer may be used to confirm the size selection before the actual implant (of that size) is placed into the pocket. The pocket and the implant are both bathed and cleansed.

The appropriately sized implant is then inserted and properly positioned within the pocket. Some implants may be stabilized with sutures to prevent it from moving out of place. The incision is then closed. Supportive tissue forms around the implant after a few weeks; and once healed, it feels like your normal underlying bone structure.

Understanding the recovery
Cheek implant surgery is not a complicated procedure; therefore, the recovery period is relatively short with many patients resuming normal activities within a few days. As with any surgery, there may be some swelling, minimal bruising, or mild pain. You will be given prescription medications to control any discomfort. It is typical to have some numb and firm areas around the cheeks and mouth, but rarely long lasting. Some patients describe their skin as feeling tight.

Chewing is limited immediately following the surgery, and a soft food diet is required for several days. The recovering patient should avoid pressure to the cheek area. You can expect to see the refined, contoured results of the implants gradually emerge after four to six weeks.

Patients decide to get an implant to decrease the signs of aging, enhance their existing skeletal framework, or bring balance to their features. Look in the mirror. If you are weary of having that tired, worn-out look, discuss your needs with your facial plastic surgeon. Cheek implants could provide a rejuvenated “new” you.