The Ogee curve is a well known aesthetic concept that is frequently applied in volumetric cheek augmentation. The cheek is a rather ambiguous facial area that defies specific linear dimensions that are typically used in facial areas such as the chin. In the front and side views the impact of the cheek is hard to quantitate. But in the oblique view the cheek area attains a profile like that of the chin where its shape can be better appreciated. As a result the Ogee curve concept has utility as it provides the injector some guidance as to where the injectable filler should be placed to get the best aesthetic result.
The Ogee curve has its origins in architecture but when applied to the face it speaks to a specific shape in the central facial triangle. It is the double curves that are seen in the oblique view where the lateral brow down into the cheek has a soft curve which becomes a second soft curve as it courses over the cheek down towards the mouth. This double curve creates a line along the central face that has a central concavity with two convexities are the upper and lower sides. While there are specific mathematical methods to create Ogee curves, this is not how they are applied in facial aesthetics. When placing fillers this is a general concept to obtain an improved facial shape.
But in designing custom cheek implants in which all dimensions are specifically created, the Ogee curve must take on more than a general concept to be maximally useful. In custom cheek implant designs the dimensions are typically created in the front, side, top and submental views. While these are helpful for creating the implant’s footprint and thicknesses, these views lack the ability to create the shape of the cheek as it transitions from the front of the face to the side. This curve of the implant is just as important, if not more important, than the thickness of the implant is in this area.
In using the Ogee curve in custom cheek implant design, the specifics of its curves are important. In most patients the upper curve is fixed and controlled by the shape of the tail of the brow bone and lateral orbital rim. (this curve can be changed if the implant goes up far enough along the lateral orbital rim) It is the lower curve in which the implant design primarily influences.
In applying the Ogee curve in cheek implant design there are two issues to consider, projection and shape. Projection is whether the lower curve meets a vertical line dropped down from the upper curve or projects out further from it. Stronger cheek augmentation results are when the lower curve of the implant design projects beyond that of the upper curve. Modest cheek augmentations results are when the projection of the two curves are equal.
The shape of the lower Ogee curve has an important impact on the result and can be classified as centric, high or low. The most common curve shape is centric. But the curve can be high or low. The shape of the curve reflects where the point of maximum projection is. This is best determined by computer imaging of the patient to see what type of cheek shape they desire.
The Ogee curve in custom cheek implant design, unlike the general concept used for injectable fillers, must take on very specific projection and shapes that will differ for each patient and their aesthetic goals.
Dr. Barry Eppley