• 
  American Society
  of Plastic Surgery
• 
  American Society of
  Aesthetic Plastic Surgery
• 
  American Association for Accreditation
  of Ambulatory Surgery Facility

SELECT A PROCEDURE: Face Lift | Mid-Face Lift (Cheek Lift) | Cheek Augmentation | Endoscopic Brow Lift (Forehead Lift) | Neck Lift | Blepharoplasty (Eyelid Lift) | Lip Augmentation | Otoplasty | Rhinoplasty

Procedure: Cheek Augmentation

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. Augmenting the cheeks will also provide a stabilizing effect on the lower eyelids and help prevent drooping. It also provides augmentation of the nasolabial folds (smile lines) with an improvement in the overall appearance.

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. The Medpor implant is preferred 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 each implant during the healing phase. The screw is left in permanently. The internal incisions are closed with stitches that dissolve.

The appropriate size of the implant and the amount of augmentation is decided ahead of time during consultation with your physician. Specific measurements are performed to help decide the implant size. This should be performed to provide a natural balance and proportional aesthetics to your face.

Anesthesia The procedure is typically performed under general anesthesia as an outpatient. In some cases you may stay at the surgical facility overnight or in a nearby hotel with a private nurse. The anesthesiologist and the surgical facility will bill separately for their services.

Duration of Surgery The operating time will vary depending on the patient and the extent of the procedure, and whether any additional procedures are performed. Generally the time is approximately 1 ½ hours.

Before Surgery Do not take aspirin, ibuprofen or products that contain aspirin for at least 3 weeks prior to surgery. Also refrain from consuming any energy drinks and 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.

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.

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 or "frozen peas" 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. You should try to sleep with your head and shoulders elevated to help reduce the amount of swelling. Sometimes an elastic wrap or support is used to give gentle compression to the operated areas after the dressings are removed. You may bathe the day after surgery.

Initial discomfort is controlled with oral medication but typically the pain is minimal. Stitches are usually dissolvable. 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 Most people return to their usual activities and to work approximately 1 to 2 weeks after surgery. It is acceptable to apply make up after 3 to 5 days. Strenuous sports and other activities should not be performed for 2 weeks. After 2 weeks you may gradually increase your activity so that you are back to your usual routine by 3 weeks. You may drive when vision is not impaired by swelling, or when you are no longer taking pain medication.

Scars Incisions are located inside the mouth and should heal without any problems. You should expect a scar on the underside of the upper lip. These incisions should not be visible. The scars are rarely problematic. The scars will typically fade with time. 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 as period of time. Some diminished sensibility may last indefinitely.

Swelling and Bruising Swelling and bruising of the face and neck or any site following surgery is normal. During the first 1 to 2 weeks your face will feel and look swollen. The swelling will start to subside after the first postoperative week. It may take as long as 2 months for the last bit of swelling to recede.

Complications

Some swelling and bruising of the cheeks and around the eyes is expected after a cheek augmentation. This peaks at 48 to 72 hours after surgery and then starts to subside. Complete resolution of swelling may take several weeks.

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 sometimes 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.

ABNORMAL SCARS Scars are rarely a problem but a small percentage of patients will develop scars that are unacceptable despite meticulous attention to detail both during and after surgery. If the scars are problematic a steroid injection will be used to improve their appearance and consistency. In rare cases the scars need to be revised surgically.

INFECTION This complication is also rare. Prevention is the key and antibiotics are given both before and for a period of time after surgery.

I mention these complications not to alarm or frighten you since the usual outcome after this surgery is quite favorable. The majority of patients are very satisfied. I present this information to you to fully educate you on the side effects, undesirable sequelae and complications no matter how remote they may be.

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Telephone: (801) 743-0700
Fax: (801) 743-0701
for more information.

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