Cheek augmentation (Cheek implants)

Cheek augmentation can be done using either implants or injections. The implants that may be used are usually made from a solid silicone material. They will not feel soft to the touch (like silicone breast implants) when implanted, and will feel and look like natural bone in the cheeks.

These implants come in various shapes. Malar implants are the most common. 

They will be placed directly on the cheekbones and will result in a more projected appearance to the cheekbones.

Submalar implants are not placed on directly on the cheekbones and are the ideal choice for those patients who want to improve the appearance of their “midface” region. This is great if your cheeks have a sunken in appearance or a permanently gaunt appearance that you would like to get rid of.

The other option is a combination of both the previous types. They will fill in the midface of the patient while also improving the profile of their cheekbones.

The incisions for this procedure are made in the top of the mouth right about at the gum line. The implants will then be slid in to position from below. This method carries some risk of infection since the human mouth has a large amount of bacteria in it. If you are concerned about that, your doctor is also able to make an incision externally instead—it would be placed near the eye, but it will leave a visible scar. Be sure to discuss your options with your doctor if you think you want the external incision option.

One important thing to note with this procedure, is that the implants MAY shift. This could become so bad that it moves up and begins blocking your vision.

If implants are not what you want,  you can always look in to fillers or injectables. Hyaluronic acid compounds, like Restylane or Juvederm can be used—but these are not permanent options. An injection of your fat can be done as well, and would provide a more permanent solution. Choosing injectables over an implant is based on your current appearance and the changes you want to make, so be sure to ask your doctor about all of your options. One great thing about these methods is that there is no scarring and your recovery time will be less than with implants—although cheek implants typically only take about a week to recover from.

Check out some before and after shots to get an idea of what this procedure could do for you:

This is a popular procedure for both men and women. As you can see in these pictures, subtle is best. Both of these patients have a very nice looking bone structure in their after images. You can see the difference the implants have made in the relaxed appearance of the face. These implants will alter more than just your cheeks-- they can make wrinkles less noticable, change the shape of your lips/mouth, and overall restore a more youthful appearance.

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Liposuction

Working out can do wonders for your body. It can help you tone up and lose weight, but often you reach a point where no matter how hard you try you can’t get that last stubborn few pounds off. This is where liposuction comes in. Liposuction is the process of removing fat from your body; it can be useful in simply taking unwanted fat off, or it can be used to help sculpt and shape your body. Liposuction is ONLY the right choice for you if you are looking to get rid of a small amount of fat, and if you have already tried diet and exercise. Any larger amounts and you will want to look in to some kind of “tuck” procedure (like a tummy tuck), which I will talk about later.

This procedure is done by removing fat using a tube and suction device (called an aspirator). There are different options for how this is done regarding fluid injection and how the tube portion works. Wet liposuction uses a small amount of fluid (a smaller volume than the amount of fat you want to remove) that will contain a local anesthetic (like lidocane), a salt solution to make it match body fluid tonicity, and adrenaline which will help contract blood vessels and reduce bleeding. The fluid will help loosen the adipose (fat) cells, and to minimized bruising. The fat is then suctioned out. Super wet liposuction uses roughly the same volume of fluid as quantity of fat that you want to remove. This is popular for procedures that are removing LOTS of fat. Laser assisted liposuction utilizes thermal and laser energy and it is even thought to increase skin tightening.  The benefits of this method over traditional methods is still somewhat contested though, so if you are going this route make sure your surgeon is very experienced. Tumescent liposuction involves the injection of large volumes of a solution (which is made up of an anesthetic and vasoconstrictor) straight into the fat you want to remove. This can be a very dangerous method if you are having a large volume of fat removed.

Those all deal with the fluid portion, but the actual method of removing the fat is related to the canula that will get the fat out of the body. There is a wide variety of options for this as well: suction assisted is the industry standard—a tube is inserted that is attached to a vacuum device and as your doctor moves it around, it breaks up and suctions out the fat cells. Ultrasound assisted uses a special tool that transmits ultrasonic vibrations in the body that emulsify (liquidate) the fat which makes it easier to suction out. This process requires the use of suction assisted afterwards to remove all of the emulsified fat. Power assisted does the same thing as suction assisted but it has a mechanical device that eliminates the need for the surgeon to move it around as much since it will move on its own.

Your recovery from this will be about a week or two before you can go back to work and normal light activities. You are going to need to wear a compression garment for up to one month. Your doctor will prescribe you pain medication and you will see your final settled results by 6 months. Prior to that, there will be considerable bruising (which will subside within a few weeks) and swelling (that will go down over the first two months). Depending on where you have this done, expect to have limited motion since you will definitely be sore.

Here are some great before and after pictures so you can see just how effective this procedure is: 

These images are all excellent examples of not only how much fat can be removed, but the benefits you can have from shaping. In some cases, the doctor can even shaped the fat removal to make your muscles look more defined (I've even seen cases where patients come out looking like they have 6-pack abs).

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