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Cheek augmentation is a procedure performed to highlight the cheekbones. In some individuals the cheekbone is somewhat deficient resulting in a more flat appearance to the face. This can be easily seen in certain ethnic groups, in certain congenital abnormalities, and post injuries to the face. It is also evident in many normal individuals as part of the norm. Cosmetic makeup (blush) is utilized to highlight the cheekbones, as prominent cheeks are considered aesthetically pleasing. Improving on the prominence of the cheekbones in the older age group also has a secondary effect of tightening the facial skin and soft tissues. Surgical enhancement of the cheeks can be performed through an augmentation type procedure using artificial implants. There are several types of implants available to produce this enhancement and the choice is dependent on your anatomy and your surgeon's choice. The predominant implant type used is Medpor (polyethylene), but silicone, Gortex and hydroxyapatite (coral) and one's own bone can also be used. Dr. Morales prefers Medpor because of its stability and predictability of results. Dr. Morales has been instrumental in developing a specific type of Medpor cheek implant that provides a very normal, aesthetically pleasing contour. He has a large experience in its usage.
Surgery The procedure is usually performed through an intra-oral incision, just above the gum line. The dissection of a pocket to insert the implant is performed, staying on top of the bony surface of the cheek. The implant is positioned in the appropriate position and stabilized using a screw that provides stability to the implant during the healing phase. The screw is left in permanently. The appropriate size of the implant and the amount of augmentation is decided ahead of time during consultation with your physician. This should be performed to provide a natural balance and proportional aesthetics to your face. Anesthesia This procedure is best performed under general anesthesia. The anesthesiologist's services are billed separately. Duration of Surgery This procedure usually takes one hour but is dependent on whether other procedures are performed simultaneously. Hospitalization Vs Ambulatory Surgery Cheek augmentation surgery is usually performed on an out patient basis. You come to the surgical facility on the day of the procedure and return home several hours after the procedure. Before Surgery Do not take aspirin or products that contain aspirin for at least 3 weeks prior to surgery. Also refrain from any herbal supplements, as some may have an effect on increasing bleeding during the course of surgery. Remove all makeup and mascara from your eyelids. If you wear contacts lenses, it would be preferable that you wear glasses when you arrive to the surgery center.
After Surgery There is little discomfort associated with a cheek augmentation. There will be a moderate amount of swelling around the cheek area and possibly under the eyes. This peaks at 48 to 72 hours after surgery and then starts to subside. Crushed ice applied to the cheeks will help during this time. Most of the visible swelling will disappear by 2 weeks. There may still be a feeling of numbness, which means that some swelling is still present. It will take several weeks before the last bit of swelling has resolved. You should not sleep on your face. Oral pain medication is all that is necessary to control the discomfort. The internal incisions are closed with stitches that dissolve. You should be able to brush your teeth after surgery but be careful with brushing the upper teeth. Your diet should be liquids (juices, milk, shakes, broths, etc.) the first 24 hours then you may start a soft diet. You should not eat foods that are hard or sharp (chips, Doritos, etc.). Return to Normal Activity Patients may go back to school or light work one week after surgery. You should avoid strenuous activity for 2 weeks. After 2 weeks you may gradually increase your activity so that you are back to your usual routine by 3 weeks. Photographs Photographs are taken at the time of your consultation. These are important aids in the preparation of surgery and become a permanent part of your record. Post-surgical photographs are also taken. Scars Incisions are located inside the mouth and should heal without any problems. These incisions should not be visible. The scars are rarely problematic. Nevertheless, you should be aware that all scars are permanent and their height, width and final color are unpredictable. Diminished Sensibility As with any surgical procedure, small sensory nerves to the skin surface may be cut when the incision is made or when skin is undermined. Portions of your face will feel numb or have less than full feeling. The sensibility in these areas gradually returns, usually with 2 to 3 months as the nerve endings spontaneously heal. During the healing process the skin of the face may become hypersensitive for a period of time. Some diminished sensibility may last indefinitely.
Complications BLEEDING This is unusual but may occur after cheek augmentation. It occurs in about 1 to 2% of patients and is more common in men. The body will absorb minimal bleeding. Ice packs to the face will help decrease this potential; however, in some cases additional surgery may be necessary. ASYMMETRY Occasionally, a minor deformity may persist following surgery. Everyone's face is never totally symmetrical. Some asymmetry may be a result of the asymmetry already present. If the asymmetry is more apparent, than a second procedure may be necessary. EDEMA This is a normal consequence of surgery and is best treated simply by elevating the head of the bed. The application of ice packs or cold compresses is usually done for the first 1 to 2 days. NERVE INJURY In addition to the small sensory nerves to the skin noted above, the other main nerve is the nerve that gives feeling to the cheek, upper lip and side of the nose. Injury to this nerve occurs in less than 1% of cases. When it does occur, it results in partial loss of feeling to that side of the face. Some numbness after surgery is normal but if the nerve is injured, then there could be permanent loss of feeling. If the nerve or one of its branches is injured due to stretching it may take 2 to 6 months for recovery. INFECTION This complication is also rare. Prevention is the key and antibiotics are given both before and for a period of time after surgery. The vast majority of patients are quite satisfied with their results. I mention these problems because I want you to have full disclosure. Should you not understand any of this information, or should you want further information, please call our office and ask. If necessary a second consultation can be scheduled.
Dr. Morales Recommends Theraderm Skin Products for his patients before and after surgery.
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