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Creating the high cheekbone look using an implant currently requires a special design to do so. Such a look is based on the natural shape and convexity of the complete zygomatic bone which includes both its main body as well as posterior arch component. There are no standard cheek implants that have yet been designed to replicate the natural shape of the bone to create this type of cheek augmentation effect.

Replicating in an implant the shape of the zygomatic bone requires a tripod design.  While zygomaticomaxillary (ZMC) complex bone (cheekbone) fractures are better thought of as a quadrapod (four legs), an implant only needs the three external legs. As the bulk of the implant has a long horizontal component mimicking the main axis of the bone, there is also anterior vertical posterior buttress leg as well as a small anterior infraorbital leg.

The key component of this cheek implant design is the long arch component. It extends back as far as the zygomatic process of the temporal bone or the temporal process of the zygomatic arch. It maintains its thickness all the way as opposed to being tapered so that its effects are visible. This is what creates the high line of cheek augmentation although I would argue this is really just an enhanced natural bone effect.

The main dimensional effect that this model cheek implant creates is to change the axis of cheek augmentation from an oblique one using standard implants to a horizontal one that more closely parallels that of the bone.

With a complete arch component to the design, placement is more challenging than standard cheek implants. The arch end off the implant can not be seen other than by external palpation during placement. The anterior infraorbital and posterior maxillary buttress legs are helpful for the implant’s placement as their position can be seen intraorally. The durometer of the implant is also firmer which is important when the thinner arch segment is being placed inside a long narrow tunnel.

Dr. Barry Eppley

Indianapolis, Indiana

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