High cheekbones, whether it is in women or men, is an often desired facial feature. Careful inspection of what constitutes the ‘high’ or ‘strong’ cheekbone look reveals that it has several anatomic components. The main portion of the cheekbone is indeed high but the prominence extends back along the zygomatic arch, stopping just short of the temporal region. A prominent zygomatic arch creates both a strong cheek line but also contributes to a submalar hollow or concavity.
Cheek implants are commonly used to try and achieve it but often are inadequate due to the implant’s shape. No cheek implant provides any zygomatic arch extension which is critical in helping to achieve this type of cheekbone augmentation result. (extended cheek implants) Fabricating custom cheek implants from the patient’s 3D CT scan is the ideal method to achieve this implant design and look but adds a significant amount to the cost of surgery.
An alternative method to fabricate extended cheek implants is to make them during surgery by hand carving. This is done using a silicone carving block. These are available as rectangular carving blocks of the dimensions of 12 cms x 7 cms and being 1.5cm thick. They are available in three durometers (hardness) which I prefer the medium or 20 durometer. Measurements and a paper template are made from the patient and then transferred to the block where their outlines are traced onto it. A large scalpel blade is used to cut out the design from the blocks and it is finished with small scissors. The image left behind in the carving block resembles that of ‘angel wings’.
The extended cheek implants are fashioned so that the portion over the zygomatic prominence is curved downward to add anterior cheek fullness. Wedges are taken on the underside to allow it to make the bend down onto the maxilla. Perfusion holes with 3mm punches are made to allow tissue ingrowth over the maxillary portion of the implant.
Extended cheek implants provide a zygomatic arch extension that is critical to create the elongated midfacial line for the high cheekbone look. Such a facial implant design can be handmade during surgery from silicone carving blocks.
Dr. Barry Eppley
Indianapolis, Indiana