Cheek implants are a fairly simple and effective method of enhancing this important aesthetic part of the face. By placing implants through an incision on the underside of the upper lip, the cheek area can be enhanced in various three dimensional ways with different types of implant designs. While once used exclusively for people with flat or deficient cheeks, its use has been expanded in the past decade to help lift sagging cheek tissues to reverse the effects of age and gravity.
The original type of cheek implant to lift up sagging cheek tissues is known as the submalar or Binder implant. It has been around now for over 15 years. Designed to sit on more of the underside of the cheek bone, it synthetically increases the fullness of the cheek bone which causes a lifting effect of the overlying cheek skin because of greater support underneath. This type of implant will not lift sagging skin as much as a true midface lift, but it is a far simpler procedure and poses no risks of any problems with the lower eyelid as a midface lift has the potential to do.
Traditional cheek implants (which sit on top of the cheek bone) can create a similar lifting effect but they also can make an artificial appearance to the midface with a non-anatomic fullnerss below the eye. This can make the cheek look too big and the eyes look artificially sunken in. This is exactly what happens when the approach to treating the aging face involves large cheek implants, often combined with a facelift. The face may be more wrinkle-free and the sagging is gone, but the face somehow looks unnatural and just doesn’t look right. In the male face, this approach often feminizes the face. In the female face, the cheek bones are just too full and they don’t fit the face well. I could name numerous famous actors, actresses, and musicians who have this look from their plastic surgery procedures (which they of course would deny) but I won’t. (as you could probably name them anyway….you certainly know they look odd when you see them)
The key to using any type of cheek implant for facial rejuvenation is…..not to overdo it. Too large of an implant is unnatural. Small to medium-size cheek implants are better for most patients. Don’t try and make the implant do all of the lifting…or make the cheek area too big. It is easy to do as it may look quite good on the operatuve table to the plastic surgeon but not so good to the rest of the world. If the cheek sagging is severe, the patient may be better off with a small cheek implant combined with a midface lift. Or just use a cheek implant alone and accept improvement but not perfectly tight skin across the cheek area. When it comes to natural vs obvious cheek enhancement, less is always more.
Dr. Barry Eppley
Indianapolis, Indiana