Traditionally, strong cheek bones and triangular facial angulation have been considered signs of beauty. This triangularization is like an upside-down triangle. Unfortunately, nature does not bless everyone with these ideal attributes. Cheek implants add to the definition of the face and help improve facial harmony using different methods. Two specific surgical procedures are malar (cheek bone) augmentation and submalar (below the cheek bone) augmentation.
Patients who opt for malar augmentation have inherited flat or very minimally prominent cheek bones, and there is no contour to their face – or they want to minimize the “cherub-cheeked” look. Submalar implants can provide a more youthful appearance to the face or enhance the results of a facelift. They “fill in” or augment the “hollows” of the cheek and improve the “gaunt look”. They “fill” or add volume to the mid face which tends to “sink in” with aging. Due to the loss of subcutaneous (below the skin) fat, in addition, gravity causes drooping or sagging of the mid face fatty tissues. Patients who have submalar implants want to enhance the natural facial contours that have become hollow and contribute to a weak, tired or haggard mid face area. These patients – men and women alike – have no substantial fatty deposits in their facial area and are looking to fill out their face. This surgery can offer a more natural-looking “high cheekbone” or fuller mid face appearance. Patients who have suffered facial trauma or have a congenital defect are also candidates for cheek augmentation surgery.
There are alternatives to having cheek implants to fill out or augment the cheek bones and mid face. A temporary method is to have one of the high-density hyaluronic acid injectable fillers placed appropriately to enhance the cheek bone contour, or have a softer hyaluronic acid that will fill in the hollowed areas below the cheek bones and the soft part of the cheek. These work immediately and effectively but, at best, last a year to a year-and-a-half in some cases. Injectable procedures can be performed in the office setting.
Another alternative to an implant to fill out the cheek or cheek bone is to have one’s own fat removed from one area and transferred to fill in the face and cheek areas that are hollow or are beginning to sink in with age and time. This is called autologous fat grafting or transfer. Usually, the fat is harvested, (meaning taken from) the area of the fat in the mid abdomen or belly area just beneath the belly button. Sometimes fat from the hip area or thighs can be used, if a larger volume of fat is necessary.
Autologous fat grafting is done under anesthesia and is an operative procedure involving both taking the fat from one area, preparing or processing it so it can be injected and used to fill in the areas of the face that need it. Initially, this result looks very good but, statistically, at least 50% or more of your own fat will absorb or dissipate over the first year to year-and-a-half. Some fat does stay, which is helpful because a secondary fat grafting procedure can be done. Occasionally, fat grafting does not seem to take very well in some individuals, therefore, other alternatives may end up being preferable.
Dr. Perkins utilizes cutting-edge computerized video imaging so that potential patients can visualize what a cheek implant looks like before deciding whether this surgery provides the look they desire. Our patients find this is an invaluable service during the consultation to enable them to make a decision about the procedure and how it affects their overall look.