Surgery » Cheek implants

What are the options for improving this area?

Injectable materials are one option. There is a choice of both temporary and long lasting injections that are suitable for use in this area. Both of these options tend to work out more expensive in the long term rather than having a permanent implant placed.

In some people fat transfer may be an option, however fat transfer usually has a quite variable persistence and frequently as much as 80% of it will disappear giving it much less reliability.

The implant

There are a number of different shapes of implants depending on whether we are just augmenting the height of the cheeks, augmenting the hollowness below the cheek bone level or whether we are using a combined implant to do a little of both. The most commonly used implants today are made out of silicone. They have been around for thirty years and they are intended as permanent implants. They have a very good acceptance and do not get rejected by the body, but care needs to be taken to avoid infection.

The procedure

Dr Oates usually performs these implants under twilight sedation in our government licensed  Academy Day Hospital (on site at Academy Facial Plastics). The procedure takes approximately one hour if done as a stand-alone procedure.

Twilight sedation is used to make you very relaxed, even sleepy. Local anaesthetic is injected, to numb the area that will be worked on. A small incision is then made on the inside of the lip quite high up, right over the area where the cheek implants will be inserted. The muscles and soft tissue of the cheeks are elevated and the implant is placed directly against the bone. Sutures go through the implants, come out through the skin are are tied over a bolster. This prevents the implant from being able to move after insertion and allows extra compression over the implant helping to minimise swelling. Dissolving sutures can be used inside the mouth, but often they are so high up that a patients tongue cannot even feel the stiches.

Following surgery, a facial compression garment that looks a bit like a skin-toned balaclava is worn by the patient. This helps to minimise swelling and ensures that the implant is secured in the correct position, at the level of the bone, and is not floating in the soft tissue.

Recovery

The facial compression garments, the bolsters and sutures would need to be worn for two or three days. After that the bolsters and sutures are removed. Some people continue to wear the facial compression garment for the rest of the week but just at night. Usually at this stage you are looking quite presentable, however you may have somewhat swollen, chubby cheeks. We provide you with pain killing mediations (however usually these are not necessary) and antibiotics, which we wish you to take until they are finished. Usually there is minimal bruising so now it is just waiting for the swelling to settle down. More people are quite presentable after one week and at two weeks people should not be able to pick that you have just had something done.

Is there discomfort?

There is some mild discomfort and on the first night you may need to take some pain killing tablets that we will provide for you. Patients rarely report strong pain and anything they have is usually easily managed with the medications.

Postoperative care

After the bolsters and stiches coming through the cheek are removed, there is really minimal post –op care. Perhaps rinsing the mouth with salt water to keep the dissolving sutures clean is useful but they rapidly dissolve.

The implants do give an immediate result, however it takes some time for the swelling to subside completely.

Risks

Washing with the antiseptic body wash, using an antiseptic mouthwash prevents infection plus we give you antibiotics in the drip and to go home with for five days. The sutures prevent malposition of the implant. Occasionally a slight inequality of implant position can occur and this may result in the need for a procedure to correct one side.