Cheek implants can be the most difficult to decide preoperatively as to their style and size. Because the cheek is an oblique structure and not a profile one, it defies any exact measured target to achieve. The cheek does have very specific zones of augmentation, four to be exact, and it becomes important to consider these cheek zones when selecting the implant style that can achieve the patient’s desired midface look.
Most cheek implant styles focus on augmenting either the malar body and/or the submalar region underneath it. These are the central zones of the cheek. While effective for some patients, they are prone to creating a bulge or bump effect particularly if the size of the implant is too big. This is because the cheek, also known as the ZMC (zygomatico-maxillary) complex, is a bony structure that has three visible legs or extensions to it that emanate out from its main body. To look more natural many cheek implants should flow into these extensions more fully.
One newer cheek implant option is the malar-arch style. As the name implies it is a midface implant that augments the malar body but has a long posterior tail to it that goes back along the zygomatic arch. It extends back along the curved arch and stops before it reaches its temporal attachment. This provides a gentle sweeping augmentation across the cheek area and achieves a more complete and natural cheek enhancement. It is also the type of cheek look seen in many models, for example, whether that is their natural look or has been created by makeup or photo editing.
It has not uncommon that I see a ‘standard’ cheek implant patient who is dissatisfied with just augmentation of the malar-submalar cheek area. Exchanging these standard implants for an extended arch style usually provides a more desired midface enhancement effect. It is the creation of a more horizontal line across the side of the face that is often sought out today.
Dr. Barry Eppley