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Cheek Implants (Malar Implants)

Cheek implants can be placed for a number of reasons:

  • For people who have had underdevelopment of the mid part of the face and an overall flatter appearance to the face.
  • For facial rejuvenation; commonly as we get older the tissues of the mid face tend to descend which looses the youthful appearance that we had. A small cheek implant can help restore the fullness of the cheekbones that we had when we were younger.
  • For patients who have sustained previous fractures of the cheekbone. In these cases if the cheek bone has not been corrected or even occasionally due to soft tissue changes that can occur following trauma, the cheekbone can appear flat and implants can help to correct the residual facial asymmetry and flattening.
  • For patients with congenital asymmetry of the cheekbone region.

 

What are cheek implants?

Cheekbone implants are usually made from either medical grade silicone, medpor or PEEK. The implants are designed to fit directly onto the cheekbone and are usually preshaped. Custom made implants can be obtained, if wished or considered necessary, in medpor or PEEK material, although a CT scan of the bony structures is required before these can be constructed.

What are the alternatives to cheekbone implants:

Non-surgical alternatives include the use of facial fillers, which are usually temporary.

Surgical alternatives to cheekbone implants are either:

– cheekbone osteotomy which is a procedure known as a malar sandwich osteotomy in which the cheekbone can be fractured out and a small bone graft, or bone graft substitute graft is placed to give more fullness to the cheekbone . This is an alternative methods to using implants as once the out-fractured cheek bone has healed and the graft has been replaced by bone there is no synthetic material in the place of the cheek down and this is the natural cheekbone position.

  • fat transfer, where some fat is harvested from another part of the body (usually abdominal wall or thigh) and transferred to the area needing augmentation.

 

How is the procedure performed?

Cheek implant placement is usually undertaken as a day case procedure under a sedation or general anaesthetic. A small incision is made in the mouth above the upper teeth. The implants are placed directly onto the cheekbones and secured with 1-2 small titanium screws to prevent any movement of the implants following placement. The wound in the mouth is closed with dissolving stitches.

Following surgery you can expect some soreness and some swelling. The initial swelling will settle over 7-10 days, however it will take a number of weeks for the swelling to finally settle and the new appearance to take shape.

 

What the risks and sequlae of surgery?

Initially following the surgery you can expect soreness swelling and tightness. This will settle with time.

Other complications are unlikely but include, bleeding, infection, facial asymmetry, numbness of the skin of the cheek and upper lip, which is usually temporary but can take a few weeks to fully settle.

Implant infection may mean the implant needs removal. If this occurs then you will need to wait until the tissues have healed before having another one placed.

It maybe possible to palpate the edge of the implant under the skin if you have thin skin.

Post-operative care following surgery:

Your mouth needs to be kept clean and you will need to make sure that your oral hygiene is good following surgery. You are advised to brush your teeth normally, just taking some care in the area where there are stitches. You will be given some mouthwash to take home which is antibacterial and should be used twice a day, morning and night. It is also of benefit to rinse following meals with hot salt water for the first few days while the wound is healing.

You will be given a short course of oral antibiotics to be taken following the surgery and the course should be completed.

Bruising and swelling is normal and to be expected, the swelling will reach its worst at 3-4 days following the surgery and then gradually settle. You are advised to take a softer diet during this initial period of healing.

I would advise 7-10 days off work following this surgery and you should avoid any strenuous sports for 4-6 weeks. Gentle exercising can be resumed 3-4 weeks after surgery.

The Face Surgeons
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