Cheek implants are a time-honored facial augmentation procedure that has been done almost as long as chin implants. With good patient and implant selection effective midface augmentation can be achieved. But the end result of cheek implant augmentation is only as good as the implant dimensions (shape and size) and its surgical placement. But even with a good technical outcome (good implant symmetry and healed without infection) the eventual aesthetic result can end up lacking in the desired amount of cheek volume or the cheek areas where the volume is provided. In many instances patients may not completely know the details of their desired result until they ‘wear it for awhile’ and see how it looks and feels.
When additional volume is desired after cheek implant surgery, such ‘touchups’ can be done with either injectable fillers or injectable fat. Either injectate material type has their own advantages and disadvantages. But each type shares the need to be placed in proximity to the cheek implants and this raises appropriate concerns about safety and the risk of causing an implant problem. (infecting the implant)
Injections can be safely done around cheek implants but the key is to stay outside of the implant capsule. (more superficial) The implant capsule is a thick layer of scar that is not easy to penetrate with an injection cannula. The blunt tip of the cannula will not easily pass through this fairly tough scar layer. However it is very easy to do with a needle injection technique. Thus when injecting around any facial implant a blunt-tipped cannula should be used.
Most secondary injections of added volume around cheek implants need to be applied either directly over or inferior to the implant’s position. In doing so it is best to come from a more superolateral direction for injection. This is because the thinnest part of the implant is posterior while the thicker end is anterior. This provides more space for the cannula to pass over the implant capsule.
While it is not an assured outcome that injecting inside the implant’s capsule will result in an infection, avoiding doing so is. With these technical tips injections of either filler or fat can be safely done around cheek implants….the most likely facial implant which may cross paths with facial injections.
Dr. Barry Eppley