Implant This, Implant That.

Ritu Chopra, MD
Article by
Beverly Hills Plastic Surgeon

When people talk about implants and plastic surgery, breast implants come to mind. But there are a lot of other types of plastic surgery implants. We uses them from head to toe, and some of them are even more popular than breast implants. But often not as apparent. Often breast implants are “out there” and on display for everyone to see. Some patients are so happy and proud of them that they speak of them often. But other implants are rarely conspicuous. In fact, the more natural and discreet these results are, the better patients like them.

 A little history lesson on implants is in order. Although you can trace plastic surgery back to India in 2000 B.C., modern plastic surgery really got going in the early 1900’s, with facial war injuries. With improved first-aid, surgical sterilization techniques and life saving measures, the injured survived and reconstructive patients were plentiful. That is when the use of flaps, grafts and implants advanced quickly. Twentieth century plastic surgery was in it’s infancy so improvised materials and techniques were the norm. Fashioning implant material out of whatever was available was commonplace. Foreign material, the patients’ own tissue or cadaver donors provided on the spot implants. For instance, some patients had the bumps removed from their noses and implanted into their chins!

….For instance, some patients had the bumps removed from their noses and implanted into their chins!


 In the 1950’s plastic materials were developed and facial implants became more common. Later, hard plastic materials gave way to flexible soft implants made out of a combination of silicone and plastic, known as Silastic. Don’t be confused here; this soft, rubbery and flexible material is solid, not fluid filled. Although silastic implants contain silicone, it is in the solid form so there is no risk of leaking or spilling. In fact, Silastic covers many, many implantable medical devices today including pacemakers, contraceptive implants and artificial hearts. It is really, really safe so it is the most common choice for plastic surgery implant material.

By ten to one, I use chin prostheses more than any other anatomical implant. These curvy little wonders add projection to the chin, accenting the jaw line. Newer models offer extensions on the end that can help fill out the pre-jowl sulcus. That’s the little indent beside the chin that can accentuate the jowl. I love to use them in concert with other minimally invasive procedures for the synergy they provide. For example; doing liposuction on the neck at the same time can almost create the visual “jaw line makeover” of a mini-facelift. And at a fraction of the cost and recovery time.

Malar prostheses are often referred to as “cheekbone implants”. They are similar to chin implants in shape and size but are made in pairs (obviously). Much like chin implants, I find it easiest to place them in the patient through an incision on the inside of the mouth. This leaves no visible scar and is actually the lowest-impact way to do it. As with chin implants, this surgical procedure heals very fast. The slight bit of puffiness in the face is similar to that of oral surgery, like wisdom tooth surgery.

 

Malar augmentation is another procedure that looks even better when you combine it with another fast-healing procedure nearby. For example: let’s say the patient feels too round faced. I have heard people describe it as pie-faced or moon-faced. They want some angularity, some accentuation of the facial bones and thinner cheeks. Weight loss often fails because it makes them look old or because the cheekiness is more of a family trait. I combine cheekbone augmentation with Buccal fat removal and a chin implant to create a more angular look. The cheekbones and chin “come out” while the cheeks themselves “sink in” to provide that svelte refinement which women in particular like.

I have had actresses and models as patients and recommended this combination. They have a unique problem. In order for their faces to be thin enough to photograph well, their bodies must become emaciated. That’s and unhealthy look so my combination of cheek bone implants with cheek fat removal helps them look thin and angular in the face while having a healthy looking body.

Luscious lips with lip implants are also taking the plastic surgery scene by storm. Temporary injections can achieve a similar result but the fact that they need to be repeated is unappealing to some patients. We have done this on The Doctors show live, under local anesthesia. It’s that easy. We make a tiny incision at the two corners of the mouth and pass the implant in. They come in several lengths and thicknesses so there is a perfect size for everyone.

Other facial implants of similar design and construction are used less often but are very handy for specific deficiencies. Angle-of-the-jaw implants, nasal implants and sub-malar (for sunken cheeks) are available. As are custom made implants that are mostly used to attain symmetry of the face and eye orbits for birth defects or after trauma and cancer surgery. These specialize prostheses are created with computer assisted design technology from CT scans. That kind of work is very rewarding for me.

Body implants are also made for our male patients. Pectoral implants can give the same look as thousands of bench presses in the gym. Calve implants can give a better look to the spindly legged gym-rats whose bodies just don’t seem to respond to muscle bulking exercise. I will be honest, I don’t like doing these cases very much because of the difficulty on obtaining a perfect result. And perfection is what these sorts of patients are looking for. The natural asymmetries of the pre-existing structures make it nearly impossible to get the left and right to look exactly the same.

Plastic surgery is called “plastic” because it is derived from the greek: plasticos – to shape or to form. Sometimes people say it’s called plastic surgery because people use credit cards to pay for it! That’s a joke. But implant surgery is one of the rare times my specialty seems to pertain to inserting plastic to make someone look more natural and normal. And be happy, which is what it’s all about!