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Cheek implants have been used for over three decades as an elective form of aesthetic midface augmentation. While known and sought after the different styles of cheek implants primarily augment the main body of the cheekbone known as the zygoma or malar eminence. This is appropriate given that the fundamental concept is to augment the ‘cheek area’.

But today’s style of cheek implants are not right for every patient seeking cheek augmentation. While the concept of making an ‘apple cheek’ prominence works for some patients it does not work in an equal number of patients seeking the procedure.

Many patients today want a higher or more angular look that also is more natural and does not stick out like an artificial midface prominence. When the actual anatomic structure of the zygomatic complex is considered it is seen that the cheek has three aesthetic legs or extensions. These include the anterior orbital (infraorbital rim), the inferior upper jaw (maxillary) and the posterior zygomatic arch extension. Thus a natural cheek augmentation implant is not shaped like an oval but more like a central mass of material that has three extensions of varying lengths. These extensions provide a natural flow of the implant into the surrounding bone, just like the natural cheek is shaped, to provide a more harmonious and blended external appearance. (aka natural appearance)

Changes in the prominences of the three legs of this more natural and comprehensive cheek implant design allows it to have different aesthetic facial effects. A thicker and longer posterior arch extension creates a line of augmentation back towards the ear as seen in many models and desired angular cheek looks. A more prominent and longer anterior infraorbital extension helps the lower eye hollowing/deficiency that exists in some cheek augmentation patients that have more congenitally recessed cheeks. A more prominent maxillary extension, which can go all the way to the nose, provides more central midface augmentation along with that of the cheeks.

Cheek implant designs can be very versatile today to provide better aesthetic enhancements and more natural looking cheek augmentation results employing the implant extension concept.

Dr. Barry Eppley

Indianapolis Indiana

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