The most common implant method of augmentation above the jawline are cheek implants. While not quite as historic as chin implants, cheek implants have been around for decades. While they can be effective for the properly selected patient, their midfacial effects are limited to the anterior malar and submalar regions of the face with today’s preformed standard styles and sizes.
But when aesthetic needs extend beyond what standard cheek implants can cover, a different approach is needed. Deficiencies of the anterior midface from the infraorbital rim down to the maxilla and pyriform aperture requires a custom implant design. Such a custom implant design covers the entire midface with an opening for the infraorbital nerve.
This infraorbital-maxillary-malar implant design looks very much like a mask. Thus the abbreviated name for this unique design would be called the Midface Mask Implant.
The surgical placement of the Midface Mask Implant is done similar to that of standard cheek implants. Given the near complete maxillary surface area coverage I prefer to place multiple perfusion holes through its maxillary surface with a 3mm dermal punch. In addition to place the implant with the infraorbital nerve coming through its designed hole, a slit is made above the hole in the implant to allow it to easily pass around the nerve and allow the implant edges to come back together above it.
With a large enough designed hole, the infraorbital nerve has plenty of room round the edges of the implant to no cause postoperative nerve compression symptoms.
The Midface Mask Implant can pull the entire midface forward. With the exception of the nose, upper lip and occlusion, it has a similar effect to that of a LeFort III osteotomy advancement. And would be an appropriate approach in cases of mild to moderate midface deficiencies where the occlusion is not needed to be changed.
Dr. Barry Eppley
Indianapolis Indiana