Originally cheek (malar) implants were used for reconstruction for birth defects and trauma related incidents. Now, they are being applied aesthetically to enhance a person's cheeks or to create symmetry within the facial structure. With cheek implants, the flatter face is transformed into one with chiseled features that can be very aesthetically pleasing.

There are also injectable options that do not create a bony structure but do augment the cheek area. Injectable fillers are often injected deep within the dermis and move when the skin and muscle moves. Permanent injectable fillers can not essentially be removed from the dermis without tissue excision if an infection, inflammation or discontent arises, Silicone and other implants, can be.

They are normally made from hard Silicone, however they can also be made from:

• Silastic, a solid, flexible plastic
• Hydroxyapatite, a ceramic that resembles sea coral
• Polyethylene, a plastic that resembles sea coral
• Gore-Tex, the same material used in high-quality raincoats
• Cadaver bone, bone from deceased human donor

The cheek augmentation surgery is most frequently performed using Light Sleep or General Anesthesia. Light Sleep Anesthesia is the use of medicines to induce a state of relaxation and a light sleep. General is more of a deep sleep and can either be in gaseous state (intubation) or intravenous.

This procedure takes from 1 to 1 and 1/2 hours to perform. It may take longer if you choose to have chin and cheek implants as well. Depending upon your facial structure the incisions will be placed as inconspicuously as possible within the hairline or within the mouth for cheek implants. Some doctors even place the incisions inside the lower eyelid area. The risk of infection is higher if an incision is placed within the mouth area but with proper post-operative care this risk can be decreased.

There may be surgeons who only wish to use a certain implant type or a certain incision. Surgeons should give you a choice, as the updated techniques are less scarring than the previous ones. The doctor may prefer an intra-oral approach where the only incisions are placed within the mouth area. No visible scars are made with the inta-oral incisions, plus they heal much faster. However, oral techniques sometimes are plagued by a higher rate of infection. Especially in those with problems with apparent plaque build up or poor dental hygiene.
Check with your doctor on the preferred technique that he utilizes. He may very well prefer the traditional methods out of not being aware of the newer ones or he may very well offer only the newer ones, with the thought that the older techniques are simply, out of date. This subject varies with surgeon to surgeon.

Although, there is normally no extensive pain related to cheek implantation, pain medication is prescribed beforehand. You may feel a degree of numbness that will normally disappear within 1 to 3 months. You may continue to wear a support brace while you sleep to allow your tissues and implant to heal in the desired position and prevent shifting in the first few weeks.
Don't be alarmed at the presence of bruising and swelling. The swelling will begin to disappear within the first 5 to 7 days. Many patients return to work with the help of camouflaging cosmetics at about 5 days post-op. The swelling resembles inflammation of wisdom teeth or their removal and sometimes this excuse is used at the office. Although please realize that the swelling may be apparent for months and the defined, chiseled look that you so desire may not become evident for quite a while.
Things to be alarmed about that are not normal:

• Temperature elevation greater than 101 degrees
• Sudden swelling or sudden discoloration
• Hemorrhage
• Increasing redness and tenderness of the wound edges indicating infection
• Allergic reaction to drugs
• Shifting of the implant

The sutures, if any, will be removed in approximately 3 to 5 days. Your face will be swollen for the first few days -- this is normal. The suture removal should not hurt extensively although your surgeon may attempt to feel the implant through your facial tissues and this may hurt a little. The swelling should very much dissipate after the first two weeks but still may have bouts of swelling in the mornings, or after you wake up.

This depends on the incision choice by you and your surgeon. It is quite possible to have your implants inserted with no visible scars, whatsoever. Ask your doctor if he is familiar with the intra-oral incision and what he thinks about it. Ask him if he is aware of the inner lower eyelid incision for cheek implants which results in NO visible scars and any infection is a rarity. Although ectropion is at risk here. Ectropion is a condition where your lower lids are pull down or gape. If you should develop ectropion, further surgery will more than likely be needed to correct it. Which could lead to more risks and more cost to you, the patient

There will be some considerable swelling associated with the trauma to the tissues, especially if there were screws involved. Bone trauma may hurt a little more than just tissue trauma so take this into account when you decide on the technique. You may feel sensations of warmth or coldness regardless if screws are used. Your mouth may be sore from the intra-oral placement and you may need to stay on a soft foods, and liquid diet because of it -- although, this is hardly enough pain to dissuade you from making an "incision decision." Be advised that you will look like a chipmunk for a while and that the chiseled definition will not be apparent for a few months. Please go into this surgery well-informed because many re-operations or removals are due to patients not being able to handle the swelling.

You can expect to resume regular activities in about 1 to 2 weeks. Although exercising should be be reserved for after the third week. It really is individual but the swelling can be pronounced involving cheek augmentation. There is bruising and of course a support will be worn at night to alleviate tissue stress and to support the healing tissues correctly. I wouldn't make any plans to attend any weddings or other functions where you will be high profile for at least 4 weeks. Most patients return to work within a week but two weeks is nice to take off during this time to allow bruising to dissipate. Plus if you have to talk a lot you may wish to stay home for about 2 weeks. Or return to work when you feel up to it. If you have a very laborious job, it is best to wait 2 to 3 weeks

The results are immediate, although you may think that the implants are too big at first glance. Give your mind time to recognize the difference in swelling and augmentation. Most patients are very satisfied with the augmentation results as long as they are aware of what to expect beforehand.

If you feel as if your skin is starting to sag around the jowls, the forehead and generally "all over," if you look tired and physically exhausted and you, in fact, are NOT. Perhaps you are feeling as if your skin is starting to become aged looking and are searching for a way to restore your appearance to its younger looking state. Then, a Face Lift is one of the options that you can take. If it is just the sagging on the forehead or eyebrows, then an endoscopic brow lift might be best for you. Full face lifts are generally saved for those of us who are more "mature." However, younger patients are seeking mid and lower face lifts today.

There is a chance of hematoma (blood clots), numbness from nerve damage and hyperpigmentation (permanent discolorations) caused by the bruising -- althoughmany patients do not bruise badly at all. There is the risk of implant shifting which results in additional surgery to reposition the implant. There is the chance of your disapproval which may result in a re-do or removal. There is also a chance of asymmetry from tissues healing differently.

The silicone cheek implants are made to last your lifetime. More than likely you will take them with you to the grave. Especially if the implants are the harder variety and screwed into place, your risk of shifting is very minor. Although anything having to do with inserting metal into bone run the risks of infection and bone deterioration. Do be advised though pressure of the implant can cause bone resorption under the implant, especially with silicone implants. Then again, everything is dependent upon the individual and as you should know there is no "never" or "definite" in medical science.