While permanent cheek augmentation can be effectively done using standard implants, such implant styles do not provide the type of cheek shape change that some patients seek. Cheek augmentation is a unique aesthetic challenge because of its unique dimensional structure which is not a classic projectional bony prominence with its interface with the anterior eye, inferior upper jaw and posterior temporal areas.
Custom cheek implants offer the opportunity to design an augmentation effect that is suited to an individual patient’s needs with shapes and dimensions that go far being that of standard implant styles. How to design an implant to meet the patient’s aesthetic goals, however, is not an exact science. Ultimately the cheek implant design must be worn for the patient to see how it ‘fits’ their face. As a result it would not be rare for a custom cheek implant patient to want to make some changes to it.
The best way for a patient to provide guidance as how to modify a custom cheek implant is to provide very specific marks on the implant itself. While all of my patients have their design files, making changes on these computerized drawings is certainly one useful way to do it. Another method that I find even more useful is for the patient to mark the desired changes on a 3D printed plastic model of their actual implant. When this printed model is available, having the patient do so is tremendously instructive.
Then in surgery the exact desired implant changes can be executed as per the printed models marked by the patient. Having 3D printed implants models really does take the understanding of how the aesthetic changes are affected to a ‘4D’ level of understanding. (the addition of a tactile sense) Patients feeling their face and then feeling the implant(s) allows for an improved understanding that the surgeon can not appreciate.
Dr. Barry Eppley