Cheek Augmentation / Cheek Implants / Submalar and Malar augmentation

Cheek augmentation is a very simple procedure that produces permanent and satisfactory results depending on the surgical artistic skills and  proper selection of your implant by the surgeon.

A small incision is made next to the implantation place, i.e. either in the crease under your lower eyelashes or inside the mouth where your gums and lips meet. A pocket is then made in the facial tissue in order to make space for inserting the implants, and stitches are made to more solid internal facial features that lie deeper in the skull or sometimes a small titanium screw is used to attach the implant to the bone. The surgeon then closes the incision by often with one stitch usually using dissolvable sutures. These typically dissolve in your mouth over time and do not require post-operative care unless they fail to dissolve.

It usually takes 45 minutes up to about 1 and half hour to complete the procedure. It can be performed alone or in combination with forehead, eyelid, facelift, nasal or chin surgery for which a stay in hospital is required.

Cheek implants are sometimes designed for reconstructive or rejuvenation. At the time when the most common implant, silicone rubber, is used, supportive tissue eventually forms around the implant after a few weeks. Once it is fully healed, the implant feels like your normal underlying bone structure.

Cheek implants can be via injections, which are sometimes temporary, or with surgical implants, where injections take only 15 minutes to an hour to administer, and the recovery is virtually instantaneous. Silicone, collagen, hydroxyapatite paste, PMMA and other substances are used for injection.

Moreover, a more structured and permanent solution is implantation of cheek implants. To improve the cheek structure and appearance, sometimes one of the following may be inserted: Allograft, Alpigraft, silicone, other synthetic materials or natural bone, tissue or fat grafts.

It usually takes 45 minutes up to as much as 2 hours to complete the procedure depending on the technique applied. In the case of cheek reconstruction after an accidents (where bone grafts may be needed) the procedure's duration may take even longer duration.It normally includes an overnight stay at the hospital; whereas, in certain circumstances it can be performed as a day case.

Cheek augmentation benefits are mostly of a psychological nature, involving emotional and social adjustment. The cheek "correction" may provide a harmonious balance with your other facial features, so that you feel happier with your look. One should remember that cheek augmentation is aimed for the improvementg of one's look improvement rather than for  perfection. It can help you in
• Correcting deficient cheeks that make your face appear drawn and gaunt
• Providing symmetry with the other facial features (nose, eyes, ears)
• Correcting facial trauma following accidents
• Enhancing patient's self-confidence and life enjoyment

An appropriate candidate for the Cheek Implant should be a person with:
• good physical and mental health, without any active diseases or other pre-existing medical conditions.
• inherited deficient cheek structure
• signs of ageing in their cheeks (hollow, aged appearance in the lower face and under the eyes)
• injuries from an accident and need cheek reconstruction

You will feel pain and tired for 2 days and will have slight swelling and bruising, which are natural. The discomfort will be cured with prescription medication.

You should have follow-up visits in the months after surgery to check on your progress. However, you will be able to go back to work after a couple of days. Although you can walk about and carry on your routine, you should avoid strenuous activities for the next 7 to 10 days.

You should restrict your diet to simple foods and keep your mouth as clean as possible to reduce the risk of infection. You will recover as soon as within 1-2 weeks, but the true result can be observed after approximately after 6 weeks.

First of all, before deciding to undergo cheek implantation, look for a best surgeon and discuss with them the risks and complications associated with the surgery as well as your expectations from it as the result of plastic surgery cannot be erased. Your surgeon may then introduce you to the techniques used, the costs and other important information you should know to know before making a decision. To help your doctor instruct you and avoid complications later on, let him know about:
• Your dental and gum conditions if he or she proposes to use incisions within the mouth.
• Whether you are a smoker

It is recommended that you discuss with your surgeon before having surgery. The following are the main questions to be asked:
• Will cheek implants improve the drawn and gaunt look under my eyes?
• Are the results I desire realistic?
• Will cheek implants get rid of my facial wrinkles?
• Where is the cheek implant performed and how long will it take?
• What technique and type of implant are most appropriate in my case?
• What kind of incisions will be used and how will the scars look?
• What kind of anesthesia will the surgeon use during the surgery?
• How much do cheek implants cost? Does cost depend on the type of material used? What other elements factor into that cost (i.e., hospital fee, anesthesia, etc)
• What is the surgeon's level of experience in performing cheek augmentation?
• What percentage of patients experience complications with the cheek implants?
• What should I expect, post-operatively, in terms of soreness, scaring, activity level and so on?
• What is Arnica Montana? I have heard that it reduces swelling and bruising.
• What about Bromelain? Does it also help with bruising and swelling?
• What happens if the body rejects the implant?

In addition to the previously mentioned questions, it is important that you inform your surgeon about any allergies and serious medical conditions you may have.

Cheek augmentation is an outpatient procedure performed under general anesthetic or local anesthetic with sedation.

As with any surgery, there are possible risks to consider. It is well known that surgical complications happen rarely. The common risks that may occur after the procedure include:

Infection: Bacterial infection can occur more often following the surgery. In some cases, infection may force the implants to be removed during an emergency procedure. If you experience pain or redness after the surgery, you should inform the surgeon immediately. The infection can be prevented by antibiotics.

Bleeding and haematoma: Bleeding usually occurs immediately after the operation and is expected to stop in a few hours. This is normal bleeding. However, a blood clot (known as a haematoma) may accumulate under the skin or in the pocket created for the implant. As a consequence, the area may swell and become increasingly painful. You should then visit the doctor.

Scarring: The scar will be small and will remain more or less visible, depending on your capability to heal. There are several methods used to heal the scars such as: using micro-pore tape, moisturizing creams, massage, vitamin E, steroid injections and silicone sheeting. 

Complications following the procedure may include:

Implant moving, or shifting out of alignment: In very rare cases, implants may shift to a new place so that a second operation is necessary for repositioning.
Implant rejection: The implant may be rejected by your body due to a "foreign object" immune system response. Implant removal will be necessary in this case.

Capsular contracture: This risk is very infrequent. It is a result of tightening of the scar tissue surrounding the cheek implant. If this becomes painful or causes a mis-shape in appearance of the cheek, additional surgery to release the scar may be needed. Certain anti-inflammatory medication that can soften the firmness may be suggested by the surgeon.

Altered Sensation: You may experience diminished sensitivity. Return to normal may take up to 3 months.
Asymmetry: There is a slight chance of asymmetry from tissues healing at different rates and bone reabsorption. If the unevenness is noticeable enough and really disturbs you, a new operation is possible.

After your surgery, your diet will be restricted to simple and soft foods or liquid in order to avoid chewing and putting pressure on your face for several days. Avoid strenuous activities and keep your face up right for a period of time.

You should also have someone else drive you home on the day of the procedure. If you live alone, you should have somebody stay with you at least the first night once you’re home. Make sure to wear a buttoned shirt that does not have to be pulled over your face. If you are a smoker, your surgeon may ask you to quit smoking for a time.

After surgery, you will be instructed to elevate your head for the first 24 hours, apply ice packs and wear the provided bandages or garments. Your diet should be restricted to simple food or, if possible, a liquid diet is better.

You should wear button-down shirts to minimize potential aggravation of the healing cheeks.

Your bandages can be replaced as needed for the first week after the surgery.

USD 1,500-1,600