Explore Plastic Surgery

As we age, one of the many facial changes is the loss of volume in the cheek area. This is most apparent in patients that are thin or have a normal age-appropriate weight. The cheek prominences become less and more saggy. In addition, the area below the cheek bone known as the submalar or buccal cheek area will often become more indented. In some patients, this can create a ‘gaunt’ or aged look. People who are heavy rarely develop this sign of facial aging as their cheeks remain fuller and more rounded, creating the ‘Santa Claus’ effect. (round and jolly but vibrant)
While the most effective long-term solution to cheek volume loss is surgical (midface lift, cheek implants, submalar implants, or fat injections), injectable fillers offer a quick and effective method of a subtle cheek enhancement. By injecting volume into the cheeks or below in the buccal area, the face can appear more youthful and ‘uplifted’. The effect is not designed to be dramatic, nor should it be, but a subtle improvement that looks natural. This is a quick solution that has immediate effects without the swelling and potential bruising from surgery.
While the effect injectable cheek augmentation is only temporary, how long it lasts will be influenced by what type of injectable filler is used. The hyalurons, such as JuvaDerm and Restylane, will last in the range of 4 to 6 months, in some cases maybe a few months longer. When using the particulated fillers, such as Radiesse or ArteFill, I would expect the effect to last longer in the range of 9 to 12 months. (or basically double that of the hyalurons)
Injectable cheek augmentation can be enhanced by the simultaneous use of Botox injections in the crow’s feet and cheek areas. The objective being to weaked the expression lines around the eyes so that the amount of wrinkling with smiling is less. The combination of these injectable midface treatments makes for a nice rejuvenation of the middle third of the face that looks very natural and relaxed. All done in less than 30 minutes and you are on your way back to work or home for the evening without anyone being the wiser!
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com/
http://www.ologyspa.com/
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

Cheek Implants for Facial Enhancement in Indianapolis by Dr. Barry Eppley

In the pursuit of a more balanced and shapely facial appearance, the cheek is an often overlooked facial feature. Even though strong or ‘high cheekbones’ is frequently commented on as desireable, the cheek is not as visible as that of its more protruding cousins, the nose and the chin. The cheek area is more subtle but an integral facial element that must be in balance with the nose, chin, and overall facial shape. With the cheek bones are diminished, the face will have a flatter appearance whichi may make the nose look bigger than what it is. In the aging face, the cheek tissues are more probe to sag off of smaller cheek bones, creating bags below the cheeks and deepening of the lip-cheek groove. It is extremely rare to have cheekbones that are too big in Caucasians.I have done cheek bone reductions only in Asians, where this is more of a cosmetic problem.

In my practice here in Indianapolis, I discuss cheek bone enhancement through the use of implants. There are no practical bone-moving procedures for cosmetic purposes for the cheek area, so implants are always used.While cheek implants are available in different materials, I prefer the use of solid silicone (rubber) cheek implants, which are by far the most commonly used. They are soft, flexible, and slide easily into place along the upper jaw and cheek bones. A cheek implant is inserted through a small incision hidden underneath the upper lip. This leaves no visible scar. Usually the cheek implant is sutured into place, however, I sometimes use a metal screw to secure the implant to the bone. This screw fixation method can eliminate one of the very few complications of cheek implants, that of shifting position after surgery causing cheek asymmetry and loss of the desired cheek projection.While any implant (foreign-body) has some risk of infection, cheek implant infections are quite uncommon.

Enhancing the cheek with an implant is not as commonly performed as that of a chin implant. The goal of a cheek implant is to provide a subtle fullness to the cheekbone area. The key to cheek augmentation is not to overdo it. It is not a facial feature in which a dramatic enhancement usually results in a better aesthetic change. There are several different styles of cheek implants today. The most basic differences in cheek implants styles are whether they are malar or submalar-type designs. Submalar (below the cheek or on its lower edge) cheek implants add fullness to the buccal area which lies below the cheekbone. This style of cheek implant is good in the aging face (where it can pick up sagging cheek soft tissues) or in the face with too much hollowing in the buccal area. The different sizes and styles of cheek implants makes it possible to make a subtle or a dramatic facial change, dependent upon the patient’s cosmetic needs.

Cheek implants are commonly in conjunction with other facial procedures including rhinoplasty, facelifts, and chin augmentation.

Dr Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis