Cheek augmentation in men is typically performed using the same off-the-shelf implants designed for women. However, it doesn’t take much thought to recognize the gender differences in ideal cheek aesthetics. The male cheekbone has distinct structural characteristics compared to the female: it is generally higher and more angular, whereas the female cheek is rounder and lower. Of course, these are general tendencies, and each patient must be evaluated based on their unique anatomy and aesthetic goals.
When examining standard cheek implants, it becomes apparent that their shapes are more suited to feminine contours. In my experience, few men desire a rounded malar or submalar cheek shape. For this reason, many of my male patients opt for custom cheek implant designs to achieve their desired look — most often described as a high, defined cheekbone. Some have come to me after unsatisfactory results with standard implants, while others have wisely recognized the need for a custom approach from the outset.
Having performed a large number of male custom midface augmentations, it is critical to distinguish between two different designs: cheek implants and infraorbital-malar implants. The custom infraorbital-malar implant is indicated for men who lack cheek projection and also have undereye hollowing. This implant differs significantly in shape and is placed through a lower eyelid incision. On the other hand, the custom cheek implant is designed for men without undereye concerns, focusing solely on cheek augmentation, and is placed intraorally.
While each custom cheek implant is unique to the patient, there are two general design approaches I have found effective for creating the coveted high cheekbone look:
1. High Anterior Cheek Implant
This design emphasizes augmentation over the anterolateral cheekbone, projecting horizontally and keeping most of the volume anterior. It may partially extend onto the zygomatic arch and lateral orbital wall for a seamless transition, with a sharper, more defined anterolateral edge rather than a rounded corner.
The high anterior design provides the most forward cheek projection possible and maintains a balanced upper and lower Ogee curve. It is ideal for patients who already have some lateral cheek width but need more anterior projection to achieve definition.
2. Extended Arch Cheek Implant
This style starts slightly lower on the posterior zygomatic buttress and extends further back along the zygomatic arch, creating a sweeping lateral effect. It accentuates the arch and adds some width to the midface.
The area of maximal projection is often placed slightly higher than the anterior style, but the projection itself is typically more subtle, as the implant volume is distributed more posteriorly. This design is particularly well-suited for thinner, narrower faces, where it has the most visible impact.
Choosing the Right Style
Each patient’s natural cheekbone anatomy and goals dictate which implant style is most appropriate. The high anterior cheek implant works best in patients with a flat midface and some existing lateral width, while the extended arch implant benefits those with a narrower, more angular facial structure by enhancing both projection and width.
To visualize the differences between these two styles, thickness color mapping — essentially a topographic representation of the implant’s shape — best illustrates their distinct shape and profiles.
When seen from the side view the zone of projection can be seen to be more posteriothan the anterior style.
These two basic custom cheek implants designs for men are not, of course, the only shape options possible. But they do provide some initial implant design guidelines and a starting point for patients to consider.
Dr. Barry Eppley
World-Renowned Plastic Surgeon