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Cheek implants come in a variety of standard styles and sizes. While such midface implant options have been around for decades, they are not right for every patient’s aesthetic needs for both genders. In addition contemporary trends are seeing a shift in the type of midface augmentation results that some patient’s seek.

Broader cheek coverages that extend back along the zygomatic arches create a stronger and more defined cheek augmentation effect. Such cheek implant styles do not currently exist and such implants have to be custom made based on the patient’s 3D CT scan. Such implants, while often called ‘model cheek implants, are anatomically known as cheek-arch style implants.

Such custom cheek implants create their more profound effects because of the larger bony and non-bony surface area that they cover. But with bigger implant coverage the risk that is most common in this area of the face with aesthetic augmentation, asymmetry of implant placement, is more likely to occur. The long extended arch of the implant magnifies any slight rotation of its placement through the limited intraoral access that is used for insertion.

To help with custom cheek implant placement, I like to have what I call orientation tabs placed on the implant at the anterior cheek portion that is seen through the intraoral incision. These orientation tabs are placed along the posterior maxillary buttress inferiorly and just below the infraorbital foramen anteriorly. If these tabs are positioned on the maxillary bone as  designed then it can be assured that the main body of the implant over the cheek and the long tail that goes back along the arch is positioned properly.

Once the implant is placed as designed, these orientation tabs can be retained and used as either fixation points for small self-tapping microscrews or can be cut off and removed.

Dr. Barry Eppley

Indianapolis, Indiana

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