High cheekbones are a sign of beauty. Cheek implants are often used for facial wasting or complaints of a "hollow" look. Cheek implants enhance both the soft tissue and bony part of the face depending on which type of cheek implant is used and the placement. Malar implants augment the bony cheek while submalar implants augment the hollow under the eyes. Care must be taken to select the proper implant characteristics for the desired cosmetic result, since each type of implant has unique properties. The newer cheek implants have the ability to provide a more natural appearance.

At your initial consultation a complete health assessment including a head, face and neck exam will be performed. Facial analysis - examining genetics, congenital abnormalities, dietary habits, trauma, disease processes and aging (to name a few) - is an important part in determining if cheek implants are right for you. A qualified surgeon will also point out characteristics unique to your face - even asymmetries that you may not have previously noticed - before surgery so that you are aware of the exact effect an implant will have based on your individual bony skeleton and facial structure.

"What are cheek implants made of?" "Is the cheek augmentation surgery painful?" "Are cheek implants safe?" In our Cheek Implant FAQs you will find answers to many questions about cheek augmentation.

When discussing cheek augmentation procedures the best place to start is by looking at before and after photos to see just what can be accomplished. As you will see in our photographs, many patients combine the contouring of cheek implants with a facial plastic surgery procedure such as a facelift to eliminate a "saggy neck" or "turkey wattle" to tightening of the jowl area. Others come to discuss neck liposuction and fat injections, which can easily be combined with chin implant. Fat injections can be used in many areas of the face including the smile lines and for lip augmentation.

Once thought a beauty procedure sought by only wealthy women, men in today's competitive corporate workplace are increasingly seeking cheek implants to restore a younger look that more typifies their energy level. Men also frequently ask about face lifts and brow lifts for correction of frown lines between the eyes or blepharoplasty for improvements in bags under the eyes.

Patients also learn about cheek implants when they seek information about improving superficial skin wrinkles in the cheek area with a chemical peel, laser surgery or similar skin resurfacing procedure. Lip augmentation surgery can also be performed in conjunction with cheek implants.

A board certified facial plastic surgeon, trained to perform cosmetic surgery exclusively on faces and necks, knows that his responsibility is to evaluate not only the areas of concern but also the motivation behind the requests. It goes without saying, a cosmetic surgery won't save a failing marriage. Similarly some patients not ready for cosmetic surgery are better served with conservative measures, such as Botox for fine lines and wrinkles or Restylane for crows feet. Patients who educate themselves about facial plastic surgery know when and if the time is right to proceed.

An important first step toward any cosmetic surgery is to have a facial plastic surgeon assess the entire picture before making specific recommendations. At an initial consultation, we will evaluate the bony and soft tissue architecture of the face, including the proportion and balance of the face, nose and cheeks. We evaluate the amount of fat in the neck area, the elasticity of the skin and the textural qualities of the skin. Skin type, ethnic background and age are important factors influencing the outcome of plastic surgery. Together we may discuss many alternatives before determining if cheek implants are right for you.

Cheek implants are a safe, effective plastic surgery procedure performed to restore balance, proportion and a younger appearance. As with all facial plastic surgery, a thorough health assessment and realistic expectations are prerequisites. Your understanding of instructions and routines is essential to a successful final result.

BEFORE CHEEK AUGMENTATION SURGERY
At your preoperative appointment our nurse will provide all the instructions for you to follow before and after cheek implant surgery. On the business day prior to the operation we ask you to call to confirm your arrival time for your plastic surgery. Upon arrival for your surgery, you will talk with a nurse (who will start an IV), discuss anesthesia (with local anesthesia and IV sedation you are asleep and comfortable) and meet with your plastic surgeon before going to the operating room. Cheek implant surgery takes one to two hours depending on the anatomy and structure present prior to surgery. If you are having a combination of plastic surgery procedures your surgery will take longer. Recovery time from the anesthetic takes about an hour and you will be discharged about four to five hours from the time of admission.

PREOPERATIVE CHEEK AUGMENTATION INSTRUCTIONS

You will be asked to come to our Lindsay House Office (not the Surgery Center) on postoperative day one for wound check and tape removal. The morning after cheek augmentation surgery, you may shower prior to the postoperative appointment.

POSTOPERATIVE CHEEK AUGMENTATION INSTRUCTIONS
Wound care
Keep dressing tapes dry and intact the evening after surgery until they are removed the next morning. Notify your plastic surgeon if the tapes fall off the evening after cheek augmentation surgery. Rinse your mouth after meals, snacks and at bedtime with dilute peroxide and mouth rinse for one week. You may gently brush your teeth three days after surgery taking care to avoid trauma to the sutures.

Medications

• Most patients complain of discomfort more than pain. Use pain medication (typically Vicodin/hydrocodone) as directed/as needed. Vicodin contains Tylenol. Do not take additional Tylenol or acetaminophen while taking Vicodin. Do not drive or drink alcohol while taking pain medication.
• Taking pain medication with food helps minimize nausea sometimes associated with pain medications.
• Most patients will be instructed to start the antibiotic (Keflex/cephalexin) when they arrive home following cheek augmentation surgery.
• It is not uncommon to have a low-grade fever for 24 to 48 hours following cheek implant surgery.
• Swelling medication (Medrol Dosepak/methyl prednisolone) is typically started when you arrive home following cheek augmentation surgery. Take with food.
• Vitamin C (ascorbic acid) helps promote healing. Take for two weeks following cheek implant surgery.

Diet
Avoid dairy products for five days following your plastic surgery. Dairy products have a bacteria that is not harmful if the integrity of the oral mucosa is intact. To protect the incisions from infection, avoid dairy products for five days. Advance diet from liquids to soft food (oatmeal, French toast, yogurt, soup, and pasta) to your regular diet as tolerated. Avoid food with sharp edges such as tortilla chips for ten days following cheek implants.

Activity
Rest for entire day after cheek augmentation surgery. Sleep with head of the bed elevated or use two to three pillows for one week after your plastic surgery. Absolutely no bending, lifting or straining. If you have little children, bend at the knees or sit on the floor and let them climb on to your lap. No driving for one week following cheek implant surgery. One week off work is recommended; two weeks off is ideal.

Always protect your face from sunburn. At this point, a hat and sunglasses are a good idea. Following cheek implant surgery, our staff will tell you when it is ok to apply sunscreen, cosmetics or facial creams. Avoid unprotected prolonged sun exposure for three months following cheek implant to prevent swelling associated with sunburn.

Please Remember!
Swelling, bruising and disrupted sleep are very normal postoperative symptoms and will decrease as the healing process occurs. Assistance with daily activities the first two days after cheek augmentation surgery is recommended.

Final Result
Following cheek implants, it takes time for the swelling to subside and for the skin to heal. Most patients return to work one week following cheek implant surgery, however two weeks is ideal, depending on the degree of privacy one is trying to maintain. At two weeks postoperatively, swelling and bruising may be apparent to you but not to many of your coworkers and closest friends.

Final results following cheek implants are not apparent for one full year following surgery. After three months, the changes are ever so subtle, although still important. Being perfectionists about our work, you may tell us you are pleased long before the one-year anniversary. However, we request that you follow-up with us at that time for postoperative cheek implant photographs so that we can enjoy your final result.