Cheek Implants (Custom)

You may be a good candidate for cheek implants if you are looking to improve the bone structure of your middle face and cheek. This includes women wanting to add a youthful feminine convexity, or men looking to add structural angularity.

The incisions for cheek implants are typically made inside the mouth. This allows for discreet placement of the implants with no visible scarring.

Most patients can expect some swelling and bruising for the first week after surgery. Usually after one week, patients can resume work and normal daily activities. Within one week, typically 90% of the swelling and bruising has resolved. The remaining 10% of settling will occur over the next 3-6 months, or sometimes up to a year.

Most patients can resume work (and are considered “restaurant-ready”) within 1 week. For social events such as weddings (guest), graduations, or holidays, one should allow at least 2 weeks for recovery.

Cheek implants last for life. They do not need to be changed (like breast or butt implants) but can be changed for size or shape modifications easily. While the implants themselves are designed to last a lifetime, individual aging factors such as skin elasticity and bone structure changes may impact the overall appearance over time.

Essentially nothing; these implants are stable so they do not corrode or degrade. The added bone structure will offer better support to the soft tissue, so people will typically age better with less skin laxity than they would have otherwise had.

In global literature between 2-5%. In our practice it is less than 1%.

This can usually be treated with antibiotics alone. Sometimes a fluid collection can be drained as well, and in rare cases the implant would be removed, the tissue would be allowed to clear the infection for 1-2 months, and then an implant can be replaced.

Yes, many patients combine cheek implants with other facial procedures such as face lift, neck lift, jaw surgery, chin surgery, or buccal fat reduction. This is common and often produces the most natural results. During the consultation, we can discuss whether combining procedures would be ideal for your aesthetic goals.

All facial implants can be custom or non-custom (stock). Custom implants are fabricated and designed from a patient’s CT scan, which we take in-office during the consultation. They are shaped and designed specifically for each patient’s anatomy and aesthetic goals. This “virtual planning” is done by computer and is reviewed with each patient along with predictive imaging prior to production of the custom implants. Adjustments can then be made to the implant design prior to production/fabrication. Non-custom (stock) implants are prefabricated in various shapes and sizes (S,M,L) and do not require a CT scan or virtual planning.* 

*In our practice we only offer custom facial implants.

Common materials for facial implants include silicone, Medpor, titanium, and PEEK (polyetheretherketone). PEEK is largely considered the gold standard and is a solid but flexible material that best simulates bone. It is highly biocompatible (accepted by the body without causing inflammation) and chemically stable so as not to corrode or break down. It is MRI-safe and radiolucent so as not to obscure future X-rays or imaging.

Silicone can be custom, but usually is not. It is has a rubbery or gummy consistency. The flexible nature has mobility and causes rubbing against the underlying bone (even if it’s secured) causing erosion of the bone.

Medpor implants can also be custom but, usually are not. They have small holes (pores) for soft tissue to grow into, which occurs progressively with time, and can make removal very complex and damaging to the surrounding soft tissue. If you have to remove a medpor implant, the sooner the better. I recommend to avoid them.

PEEK is a solid and smooth material that is always custom. These are always secured to the bone and I feel have the best surface characteristics, esthetics, and functionality to simulate chin bone (or cheek bones and jaw angles). They can be removed easily, and typically feel completely natural.. most patients describe them feeling “like myself”, “like nothing”, or “I don’t feel it”.

You will notice an immediate improvement after surgery, though swelling will obscure the final result initially. The majority of swelling typically resolves within the first week.

7-10 days, after the one-week postoperative appointment.

1-2 hours.

It is important to choose a surgeon who has 1) the training and skill set in treating the maxillofacial structures, as well as soft tissue aesthetics of the face, head, and neck, and 2) An aesthetic sense that matches the patient’s.

The most common answers from patients who have facial implants: “It feels like nothing.” “I don’t feel it.” “It feels like me.” “I can’t even tell that something there.” “It feels completely natural.”

When the goal is to create bone structure, filler is not the right option for several reasons. It is a soft material, so it does not lift or build structure, it “fills”. Many patients are satisfied with their fillers at first, but after 5-10 years of filler treatments, they feel their faces look swollen, lumpy, heavy, or fat. They also can stay in the body for 10 years or more. Some literature suggests that large amounts injected over the years expands the skin and soft tissue, resulting in loose skin.

A CT scan is required for proper diagnosis and evaluation of the bone structure so that the custom implants can be designed accurately. It is also needed to rule out any other complicating anatomical factors that would affect decisions regarding the treatment plan.

Typically yes. Some treatments, such as ulthera, do not recommend treatment around metal. All custom PEEK implants will have small titanium screws that secure the implant in position. This should be communicated to the provider before the skin treatment, so that they can be mindful when treating the specific area. Lasers, microneedling, fillers and Botox are fine. *treating providers should always be made aware of these implants in advance.

No.

Yes, no problem. Just let the technician know beforehand.

Yes, facial implants are considered a very safe procedure when done properly. They have a very low infection and complication rate. Facial implants have been placed for several decades, so it is not a new procedure. Techniques and materials have continued to improve. They are not only used for cosmetic purposes, but also reconstructive purposes, near vital structures such as the eye, brain, and spine with excellent safety metrics.