The cheek area is one of the most common types of facial augmentation procedures. While long ago once only achievable with implants, many more cheek augmentations are performed today by less invasive means with injectable fillers and fat. They offer a cheek augmentation effect with minimal recovery and generally a very low chance of any significant complications. They also offer the ability to place the volumetric effect right where the patient desires it to be.
But despite the benefits of an injectable approach for cheek augmentation, many patients will eventually tire of the need for repeated injections and their associated costs. For those who wish to continue their cheek augmentation effects an implant approach is needed. One of the benefits of the prior injections is that the desired aesthetic effect has been established. This provides a guideline by which to choose or design the cheek implant needed to replicate it.
When considering cheek augmentation it is important to establish the zone or footprint of the desired effect. Because the cheek ‘turns the corner’ from the front of the face to the side of the face, the zone of augmentation desired is extremely important to initially establish. Considerations of implant thickness, while important, are secondary to the zone of augmentation concept.
One of the most common cheek augmentation zones, which certainly applies to what most men want, is the high cheekbone look. This is a distinct type of cheek augmentation effect that has two specific characteristics, 1) it mainly follows the infraorbital-malar skeletal line and 2) it extends posteriorly and augment the tail of the cheek (zygomatic arch) as well as its main body. It benefits those patients in which the prominence of the main body of the cheekbone has an inward curve and the very posterior aspect of the zygomatic arch is the point of widest midfacial width.
The key to the high cheekbone look is that it creates a linear line of augmentation across the midface. This includes part or all of the infraorbital rim and the entire zygomatic arch. In doing so a more convex midface arc is formed which crosses the main cheek area.
Adding the dimensions (thicknesses) at various points along this implant arc determines the strength of the high cheekbone look that is achieved. It is important to consider being conservative with these dimensions, particularly across the main body of the cheek, as their effects are more significant than one would think because of the surface area effect of the arc. It is also important to not try and make the main body of the cheek have an increased thickness that approximates that of the posterior zygomatic arch…as that will make it too wide and look very unnatural.
Another important concept in achieving the high cheekbone look is to assess the Ogee curve of the implant shape. When looking at the convex shape of the curve and where its mid portion lies, also helps in determining the ‘height’ of the high cheekbone implant look.
Dr. Barry Eppley