Prominent well-shaped cheekbones are important in achieving a well-balanced face. Flat or underdeveloped cheekbones have several causes. Thy may be caused by the shape of the underlying bone or a lack of soft tissue (fat) over the cheekbone (malar) prominences. As we age, we loose fat from the face and cheeks, so that the malar prominence becomes bony.
Cheekbone shape is also important to facial appearance and must be considered in deciding on the best treatment. In your consultation a detailed photographic and sometimes 3D analysis will help with treatment planning.
Flat cheekbones can be treated by augmenting the bone with implants or by augmenting or reshaping the soft tissues.
Soft Tissue Procedures.
Dermal Fillers provide a simple and effective way of enhancing the prominence and width of cheeks. Hyaluronic acid fillers such as Juvederm Voluma or Perlane are a good choice for cheek augmentation. Dermal fillers may be used to enhance flat cheekbones or help reverse the effects of aging. Hyaluronic acid fillers gradually dissolve which means the treatment needs to be repeated every 12 to 18 months
Fat transfer involves injecting your own fat into the cheeks. Fat is harvested from the abdomen or thighs by a small liposuction device, prepared in a special centrifuge and then injected into the cheeks. Fat transfer can give natural long lasting cheek augmentation.
Midface lift. Flattening of the cheeks with age is often caused by sagging of the cheek fat pads. A midface lift can be a very effective way of restoring the natural youthfulness of cheekbones.
Cheek implants are commonly used to enhance flat cheekbones. They are usually inserted through an incision inside the mouth, but may occasionally be placed through eyelid incisions if eyelid surgery is being undertaken at the same time. They may be preformed or custom made.
Preformed Implants are usually very effective. They are made of many materials, but we generally prefer silicone or Medpor implants. Preformed implants come in a wide variety of shapes and sizes and careful planning is needed to ensure the correct implant is used.
Custom-made Cheek Implants are engineered to exactly fit the bones of your cheek using information from a CT scan. The computer-assisted design ensures that the implant is exactly the correct shape. Custom-made implants are usually made from PEEK.
Overly prominent cheekbones can be reduced through an incision inside the mouth, eyelid or within the hairline. The type of operation depends on where the cheek is too prominent. Cheekbone reduction requires careful planning and it is usually necessary to have a cone beam CT scan to determine the best operation for you.
Many procedures are available to change the shape of cheeks and to decide on the best treatment, a facial analysis is undertaken. This often involves a simple analysis and morphing of digital photographs of the face, which can be undertaken at your consultation. Occasionally, more complex problems require an X-ray or cone beam CT scan to show the shape of the underlying facial bones.
Frequently Asked Questions
Surgery to the bones of the face usually produces some swelling and bruising, which may take several weeks to settle. Temporary numbness of the cheeks can occur following surgery. It usually disappears within a few days, but occasionally prolonged numbness can occur.
Insertion of implants inevitably carries a small risk of infection, although happily this is uncommon.
Surgery is usually performed under general anaesthetic and there is a small risk of chest infection, especially among smokers. Numbness of the cheeks may occur depending on the area operated on and there is a very small risk of weakness of some of the muscles of the face.
Occasionally, implants can become displaced, but fixing implants with small titanium screws reduces the risk of this. All operations carry a small risk of infection. If there is a significant infection the implant will need to be removed by surgery.
If the operation involves incisions within the mouth, it is important to have a dental check-up before surgery and often a visit to the dental hygienist is advisable. If you smoke, you will need to stop smoking for two weeks before surgery and one week afterwards. Smoking reduces the blood flow to the skin and can prevent healing.
These operations are usually under general anaesthetic and often require an overnight stay. You can expect a moderate amount of soreness and discomfort in the first two days.
Following the operation, it is usually necessary to sleep for the first night with the head of the bed raised to reduce the swelling. It is also important to keep your mouth clean. Mouthwashes will be provided and it is important to take care not to touch the stitch lines whilst brushing teeth.
Following your procedure, your surgeon will ask you to book an appointment one week post-operatively for removal of any non-dissolvable sutures. If you need pain relief, you can take over the counter painkillers, such as Paracetamol or Ibuprofen. It may take 24 hours to recover from your anaesthetic. During this time you should not drive, drink alcohol, operate machinery or sign any important documents.
If you have any concerns after your procedure, you should contact the office or our emergency number outside normal working hours for advice. If you find that your swelling, redness or pain gets worse or if you develop a high temperature, it is important to contact us as soon as possible at the practice.