The high cheekbone look is a specific form of cheek augmentation requested often by men but sometimes by women as well. It is a well known aesthetic facial look externally but what creates that internally at the anatomic level is not as well described. Flat cheeks are typically associated with am inward rotation of the cheekbone (zygomatic major) and a flat zygomatic arch.
What separates traditional cheek implants from high cheekbone implants is their location on the bone. Standard cheek implants sit partially off the convex portion of the zygomatic major into the submalar which is why they create an anterior fullness to apple cheek look. In some cases surgeons even placed them largely onto the underside of the cheekbone into the concavity of the face of the maxilla which is most convenient from the intraoral approach which is commonly used.
In the high cheekbone implant it it positioned completely on the convex portion of the zygomatic major bone and then follows back along the zygomatic arch. This gives it a near horizontal axis of orientation across the upper midface. This produces a more ‘skeletonized’ or defined appearance to the cheeks as it is pure bone augmentation. The implant shape is definitely oblong (longer than it is wide) which is different than the oval shape of standard cheek implants.
The high cheekbone implant does a good job of creating an Ogee curve that did not previously exist in the flattened cheekbone by making the bottom portion of the double S curve more evident. Ideally the cheek portion of the curve protrudes just a bit further than the upper brow portion of the curve.
One unique ancillary procedure that applies to the high cheekbone implant and not to the standard cheek implant is defatting, usually with buccal lipectomies. Reducing fullness below the high cheekbone implant helps create further definition because the implant sits on the bone and not below it. This is unlike the standard cheek implant which sits almost directly over the buccal fat area and thus its removal would have no benefit.
Dr. Barry Eppley
World-Renowned Plastic Surgeon