Facial Implants
Q:
I have had cheek implants for approximately ten years. Would removal of these implants result in any kind of deformity in my face?
A:
It is impossible to give a patient-specific answer without direct examination, so I will respond in general terms.
The most common forms of cheek implants are shells of solid silicone. They are usually placed directly over the body of the zygomatic bone ("cheekbone"). The subcutaneous fat layer, overlying the cheekbones, is very thin. Over a period of years, it is not uncommon for the implant to create a thinning of the fat overlying the bone. In such a case, late removal can leave a depression at the site of the previous implant.
While there may be a difference in opinion as to whether to place the implants initially, once in place, it is usually better to leave them, unless they are causing problems. If removal is necessary, some form of additional cheek lift may be required, to compensate for the depression.
Q:
I’m considering having cosmetic plastic surgery. What type of surgery might be recommended to make my jaw line more defined/stronger?
A:
A strong, well-defined jaw line is a signal mark of beauty, youth and fitness for both men and women. Fortunately, this is one area where plastic surgery offers significant improvement to people of any age group. Younger patients, with resilient, elastic skin sometimes can benefit from liposuction of the neck. This is a fairly quick operation, with minimal down time and minimal scars. Older patients may also benefit from liposuction, although lax skin and underlying muscles may need to be addressed as well with a facelift or neck lift, both of which are lengthier operations. Oftentimes, in patients of any age, a chin implant may be considered. The combination of increasing the size of the chin and reducing the volume of tissue beneath the jaw line produces a strong, youthful profile.
Q:
I am considering chin augmentation, but I don't know whether or not my complaint can be fixed. My complaint is this: Not only do I have a small chin in profile, but from the bottom of my bottom lip to the indentation where my chin actually starts, there is a big space, about an inch. I actually want my chin to "start" right below my bottom lip, not an inch below it. I was wondering if this can be changed through surgery, and if it can, will there be massive scarring or an artificial look?
A:
I believe that your condition could be corrected with surgery. There are several techniques available, and selection depends on the individual's condition. If your chin is small but your bite (the way that your top and bottom teeth come together) is good, then you would be a candidate for augmentation with an implant or by advancing forward the bottom portion of your jaw around the chin area (advancement genioplasty). Both procedures can be performed from inside the mouth or through a small incision under your chin. If your bite is off and your lower teeth sit behind your upper teeth with your mouth closed, then you might be a candidate for an advancement of your entire lower jaw (sagittal split advancement osteotomy). This is a more complex procedure but is also done from inside the mouth, and there are no external scars. All these procedures can significantly improve the appearance and achieve facial balance.
Q:
I'm very interested in facial implants. I have a few questions: 1) Can they be felt and seen through the skin after? 2) What is the best material for them, Gore-Tex or silicone? 3) Can I wear them for my whole life or I will I need to swap them in 10-15 years? 4) Is there any chance my cheeks will be asymmetrical?
A:
These are the answers to your facial implant questions:
1. Facial implants should not be readily palpable or visible.
2 .There are many materials utilized for implants of the face, with Gore-Tex and silicone being the most common.
3. Unless the implants become complicated or problematic in some way, they can stay in place for life.
4. There is always some facial asymmetry before and after surgery, but it is usually not very noticeable. Sometimes corrective surgery is required if the asymmetry becomes too great.
Q:
I see lots of information on chin augmentation but have yet to see any articles on chin reduction. Is there anything that can be done for someone who has a protruding chin?
A:
A protruding chin can be treated with a procedure called a sliding genioplasty. With this procedure the bony chin is cut and slid back. The chin is held in the new position with a small bone plate and screws. There are no incisions or scars on the face. An incision is made in the mouth inside the lower lip.
Sometimes when the chin is moved back, fullness under the chin can occur. Depending on how severe this fullness is, it may be improved with liposuction. The liposuction can be done at the same time or at a later time as a staged procedure.
One word of caution: this is a difficult procedure. Make sure your surgeon has experience doing sliding genioplasties. I recommend consulting with a surgeon who is an ASAPS member.
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Note: ASAPS cannot give advice about specific medical problems nor should answers provided by responding surgeons be substituted for a personal medical/surgical consultation. Sorry we can't answer all questions. We try to select questions that have the widest general interest.