Facial Enhancements: Cheek Implant (Malar Augmentation)

Historically many cultures, including our modern western civilization, have considered prominent or high cheekbones a sign of physical beauty and of youth.

Malar augmentation by injection of fillers or cheek implants can give women and men the high cheekbones they desire or used to have. This surgery, although not designed for everyone, can give definition to a face that has a flat contour because of underdeveloped cheekbones or aging. Our facial bones shrink as we age. Candidates for malar augmentation is the individual with a long, narrow face or one with a very round face and flat cheeks. It can also benefit people with asymmetries or congenital defects. This surgery can be performed in conjunction with other facial surgeries such as blepharoplasty (surgery of the eyes) or rhytidectomy (facelift).

Implants are permanent, fillers may be temporary or permanent. When implants are used, they are made of teflon or silicone and inserted thru incisions in the lower eyelid, mouth, or through facelift incisions. 

BEFORE SURGERY
Prior to surgery, a complete medical history is taken to evaluate the general health of the patient. A careful examination is also conducted. Dr. Gordon will describe to you the type of anesthesia to be used, the procedure, his choice of implant material and why, and what results might realistically be expected, and possible risks and complications. Digital photographs and imaging will be done before surgery to illustrate the amount of improvement. Preoperative instructions will include the elimination of certain drugs containing aspirin in order to minimize the possibility of excess bleeding. Antibiotics will be prescribed for a few days prior to surgery to prevent infection. The areas to be worked on are carefully marked.

THE PROCEDURE
Malar augmentation can be performed in the accredited Complete Cosmetic Surgery Center or Spring valley Hospital depending upon the patient and Dr. Gordon’s preference. It can be performed under general anesthesia with the patient asleep or under I.V. sedation with local anesthesia in which the area is numbed and the patient remains awake. Pre-medication may be administered to relax the patient.

The face is thoroughly cleansed with an antiseptic cleansing agent after which an incision is made either inside the mouth or immediately below the lower eyelids. With the internal approach, the most frequently used procedure, the incision is made between the upper gums and the cheek. The soft tissue is elevated, creating a pocket over the cheekbone. An implant, usually triangular in shape, is then inserted. The implant is often made of silicone or teflon or other pliable prefabricated material. Tiny sutures are used to close the incisions.

If the external approach is used, a very fine incision is made directly beneath the lower eyelash, within the natural crease of the eyelid. The implant is positioned in the cheek area through this incision. Dr. Gordon also likes to use an approach that goes through the lower eyelid from inside out. Fillers, when selected for use are injected through the cheek skin over the existing cheek bones.

FOLLOWING SURGERY
Sutures are removed within a week. Pain connected with the surgery is minimal to moderate and is controlled with oral medication. Antibiotics may be prescribed to prevent infection. Some temporary swelling and bruising of the face are to be expected; however, keeping the head slightly elevated when reclining and applying cold compresses may help reduce swelling. Chewing may be difficult for about two weeks, and tightness or numbness around the treated area may occur for a period of time. Brushing the teeth is often difficult for several days.

Complications of infection are rare; however there are certain inherent risks connected with every surgical procedure which should be thoroughly discussed with Dr. Gordon. Patients can minimize complications by carefully following his directions.

If you are interested in learning more about malar augmentation, please call our office and we will be happy to answer your questions.