Standard cheek implants are designed to augment the main body of the cheekbone (zygomatic major) and have an oval shape to do so. This creates an anterolateral fullness which is primarily seen as more of an ‘apple cheek’ effect in malar styles) and an expanded version of that by filling in the soft tissue area below the cheekbone in malar-submalar styles. These implant shapes usually work much better in women than they do in men. In men such cheek fullness tends to feminine the face and/or does not create a well defined cheek appearance than many men seek. The need for a better cheek implant style for men as well as to meet more contemporary aesthetic desires for some women who seek for a higher cheek look requires a different implant style/shape. Such a high cheekbone look is created by an implant design that more closely follows the natural shape of the zygomatic body and arch for an extended linear or sweep effect across the entire cheek area. Technically one could call this design an anatomic cheek implant given the area that it covers.
The relatively common occurrence of cheek asymmetries and dissatisfaction with the results of standard cheek implant in some patients adds to the need for custom cheek implants. Implant designs that encompass more of the surrounding areas such as the upper maxilla, zygomatic arch, and extensions over onto the infraorbital rim require extended unique design shapes that have more extensive and complete mid facial augmentation effects. In patients that often seek ‘bigger’ cheek implants or cheek augmentation effects this more commonly refers to a broader surface area of bone coverage, not necessarily that it is thicker than what is available in off-the-shelf implant shapes.
Many extended cheek-arch implant designs can be successfully inserted and positioned through an intraoral approach as all standard implants are designed to be done. But when there is a significant anterior (infraorbital) and/or posterior (zygomatic arch) extension(s) a subciliary lower eyelid placement approach is preferred. This provides an improved chance for desired implant positioning as it provides direct visual access to the more linear form of the cheek implant.
Dr. Barry Eppley