CHEEK AUGMENTATION

In Western cultures, prominent cheekbones are considered aesthetically pleasing. This procedure is infrequently performed purely for cosmetic purposes because it can have a very dramatic effect on a patient's appearance. However, it may be necessary to bring the facial features into balance and harmony. Cheek augmentation is specifically designed to create more prominent cheekbones (malar bones), producing a more youthful appearance and/or achieving facial harmony.

Some important facts about cheek augmentation:

• This procedure is often performed in conjunction with a rhinoplasty (nose reshaping), facelift, liposuction of the chin and neck area, and/or chin augmentation/reduction.
• A number of synthetic materials are currently being used as cheek implants.

ALTERNATIVES TO SURGERY
There are no alternatives to cheek augmentation. A few make-up techniques can give the appearance of more pronounced cheekbones, but nothing will contour the cheek area other than surgery.

PREPARING FOR SURGERY
Your physician should evaluate and assess the position of your cheekbones to determine facial harmony and balance. Cheek implants can produce a very dramatic change in your face, so it would be advisable to discuss with your doctor the actual size of the implant to be used. Your doctor may recommend cheek implants or a chin implant in combination with a facelift to achieve the desired results. Be absolutely clear and in agreement with your doctor about your desired look.

You will also be given pre-and postoperative instructions which will include information on eating and drinking and what prescription medications to take and those to avoid. Be sure you and your physician agree on the surgical approach and understand the potential risks and complications involved with the procedure.

THE PROCEDURE
There are three methods available for the placement of incisions. They can be placed inside the mouth, in the crease between the upper lip and gum or through the lower eyelid.

Whichever incision is used, pockets are created and the implants are placed in position under the tissue on the cheekbones. At that time, the implants may or may not be sutured or held in place with very small surgical screws. The incision is then sutured. If the incision is inside the mouth or inside the lower eyelid, absorbable sutures are used. If the incision is on the outside of the lower lid, the sutures may or may not be dissolvable. After surgery, a dressing will be applied to minimize discomfort and swelling. The severity and duration of such side effects may vary, especially if another cosmetic procedure was performed at the same time.

Anesthesia
A malarplasty can be performed under local anesthesia with intravenous sedation or under general anesthesia. The type of anesthesia is dependent on the extent of the other procedure to be performed, the doctor's choice, and the patient's medical history or desires.

Length of Procedure
This procedure should take approximately one and one-half to two hours.

Level of Pain/Discomfort
Generally, with cheek implants there is minimal to moderate discomfort during the postoperative period. Some people experience absolutely no discomfort at all.

PRE- AND POSTOPERATIVE INSTRUCTIONS
The following suggestions are intended to make you feel more comfortable and help you heal:

• Stop smoking, discontinue the use of alcohol, and stop taking vitamin E and any medications containing aspirin or ibuprofen (two weeks pre- and postoperative is usually recommended). Check with your doctor
• Follow directions regarding any ointments to be applied and/or cleansing of incisions. If incisions are inside the mouth, rinse your mouth as many times a day as directed.
• No aerobic activity for at least three weeks after surgery.
• Keep the head elevated at all times for at least the first week, optimally two weeks.
• For the first twenty-four hours, stay on a liquid diet, and avoid food that is too hot.
• For about a week, avoid excessive talking, laughing, and heavy chewing (stay on a soft diet). Brush your teeth gently.
• Do not rub your cheeks-be gentle for a minimum of a month.
• Expect some numbness in the areas treated for eight to twelve weeks.
• Your doctor may instruct you to apply cold compresses for twenty minutes every hour for a minimum of forty-eight hours.
• Postpone any dental work until six months after cheek implant surgery.

RECOVERY
You can plan on approximately one week to ten days for the initial healing period. It is important that you keep your head elevated at all times for at least a week, optimally two. You should not lie face down or bend over for three weeks. Stitches used to close the incisions inside your mouth usually dissolve within about 10 days.

At the beginning, you can expect your upper lip and cheek area to feel full, tight, and tender. The cheek area may be swollen and black and blue. Expect some numbness (as if your lip had been injected with Novocain) and a tight feeling in the treated areas for an average of eight to twelve weeks. The swelling should lessen daily, with some minor swelling remaining after the first few weeks. The bruising can last, on the average, anywhere from five days to several weeks but should diminish daily. Remember-everyone is different.

RISKS / COMPLICATIONS
Although problems are unlikely, you need to be aware of what can happen and what action you should take. Most risks/complications will be avoided if you make an informed decision, choose a qualified physician, and follow your physician's instructions.

Complications that can occur include injury to the nerves (usually temporary), rejection of the implant (very unusual), infection, and improper positioning or shifting of the implant (unlikely). You should be aware that your ability to move your mouth and lips might be diminished temporarily.

STILL YOU…ONLY BETTER
Cheek augmentation can be a subtle or dramatic change depending upon the amount of cheek contour to begin. Cheek implants can provide a refined look that will create more harmony with all facial features.