What are Cheek Implants?
There are two main indications for considering Cheek Augmentation. The initial is having relatively flat cheeks. This is usually a racial or genetic appearance that is often thought to be less attractive than having high cheekbones. The procedure is usually sort after by younger people in their twenties to forties. The sub malar implant is very similar to the cheek implant but it is slightly lower, below the actual height of the cheekbone into the hollow that develops as the face ages and loses volume. In our information sheet ‘The Ageing Face’ it explains four main aging factors:
Sunlight – which damages the quality of your skin
Folding of your skin – which then produces creases in the skin
Gravity – which makes things droop down, such as jowls
Volume loss – such as developing hollow cheeks
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.
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.
Dr Oates usually performs Cheek Augmentation under twilight sedation and local anaesthetic at Academy Day Hospital. The procedure takes approximately one hour.
Twilight sedation is used to make you very relaxed, even sleepy. Local anaesthetic is injected, to numb the area. A small incision is then made on the inside of the mouth 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 and 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 stitches.
Following surgery, a facial compression garment 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.
How Long do I Need off Work?
Approximately between 7 to 14 days off work, depending on the amount of physical activity involved in their line of work.
Who is a Good Candidate for Cheek Augmentation?
Someone with the following characteristics:
- Flattened appearance of the mid face
- Cheeks that lack definition
- Hollowing cheeks
Who is not a Good Candidate for Cheek Augmentation?
Someone with the following characteristics:
- Unrealistic expectations
- Impaired healing
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 medications (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.. 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. 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. The implants do give an immediate result, however it takes some time for the swelling to subside completely.
Bruising and swelling
The amount of bruising and swelling will vary from person to person. Although current techniques do help to minimise this, occasionally some patients will experience more. The swelling and bruising does not affect the final result. Ice pack (for at least 30 minutes each hour) will help to reduce swelling and most people find it is no longer a significant concern after 1 – 2 weeks.
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.
Pre and Post Operative Care
Pre and post operative care is managed by our registered nurses. This will include pre operative assessment and post operative wound management.
Risks and Complications
Washing with the antiseptic body wash, using an antiseptic mouthwash prevents infection. We give you antibiotics intravenously 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.
I am Interested What Now?
Your first step is an initial consultation with Dr Oates. If you have a GP referral you will be able to claim some of the cost of the consultation from Medicare. If Dr Oates decides you are a suitable candidate for Cheek Augmentation and you want to go ahead, a booking for surgery and the pre operative care is scheduled. The usual waiting period is three to four weeks.
You may wish to speak with our nurse consultant prior to seeing Dr Oates. During this complimentary consultation, the nurse consultant can discuss both surgical and non surgical options to treat your concern(s).
For more detailed information on Cheek Implants, visit http://www.facialplastics.com.au/pd32-56/cheek-