My cheeks are beginning to drop, my doctor suggested cheek implants. Can they be placed without a cheek lift first or is it better to try a cheek lift first?
Cheek Implants Before Lift?
Doctor Answers 10
Augmenting cheek area
There are many ways to augment cheeks.
First, temporary augmentation can be achieved with temporary fillers, preferably hyaluronic acid such as Juvederm XC.
Sometimes a facelift with a volume adjusting technique (not a standard or extended SMAS, deep plane or composite) can enhance cheek volume.
Sometimes, a cheeklift (and there are many different techniques, referenced in several articles and chapters below) is the right approach.
Last, volume can directly be placed by enhancing soft tissue, with fat injection, nontraumatized autologous fat-fascial grafts (LiveFill(R).
My preference is to accomplish everything at once, with the proper technique.
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Cheek augmentation with implants
Cheek implants are simply a solid silastic silicone implant that restores facial volume. However, if by “cheeks are beginning to drop” you mean jowls, then a facelift would be appropriate. The facelift addresses the jowls, tightens the neck, and loose facial skin. Cheek implants are often placed at the same time as a facelift if needed for facial rejuvenation.
Sequence of Cheek Lifts and Implants
Do either the cheek lift or the implants first - do what is best for you at this time. Over many years, I've done it both ways, and even together,during the same operation.
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Cheek Implants versus Midface Lift
Both procedures have different indications and can not be done simultaneously. From a technical standpoint, implants should not be done BEFORE and midface or cheek lift. It is unfeasible to do the lift with implants in place.
Implants should be used for patients that have midface aging due to an underprojected facial skeleton. Lack of cheek bone volume can lead to poor support of facial tissues and early midface aging.
Midface lifts or Cheek lifts work best in patients with appropriate bony skeletal support who need the soft tissues of the cheek elevated to a more youthful position.
Any experienced surgeon should be able to recognize the difference and provide you with appropriate advice for your individual facial concerns.
Best of Luck!
Try injections first before cheek lift
While cheek implants are permanent, you may wish to consider trying injectable fillers such as Radiesse or an HA filler before you commit to implants. I find that fat transfer is usually much better for most patients seeking volume, although you may need more than one procedure to achieve lasting results. A midface or cheek lift can be performed as part of a facelift to correct sagging as well, with excellent long term results. You should allow for more time for resolution of swelling however. See an experienced board certified surgeon who specializes in the face.
Cheek implants before or after a cheek lift depends on what the exact problem is.
If the cheeks were always under developed and need more volume only, this is usually done with silicone implants. It can be done with fillers such as fat, or Radiesse, etc. If the ceek is sagging as well, then you would need a cheek lift with or without implants. See an experienced facial surgeon and let him tell you what he thinks is best for you and WHY!
Cheek implants, malar and submalar implants have their indications, though it is very small.
Fat injections can be very permanent and feel very natural.
If indicated a SMAS face lift can elevate the cheeks and give volume.
If you have sagging cheeks then a face lift is more logical.
Cheek augmentation technqiues
There are many ways to augment a cheek from temporary fillers to longer lasting fillers or even implants. Cheek implants can be done at the same time as a facelift or can be done prior to or after a facelift. I always recommend to my patients to use temporary fillers first to make sure they like the effects and then consider longer lasting or solid implants. I hope this information helps.
Consider fillers for "non-surgical" cheek implants
As Dr. Rand has stated, it is also my impression that cheek implant surgery has declined in volume. This surgery, although popular in the past has minor problems which made it a procedure with a relatively hihg revision rate. Fillers can be adjusted with age so as to accomodate aging.
Cheek implants vs fillers
I believe the amount of cheek implant surgery has dramatically dropped with the advent of many longer term fillers. The advantage of the fillers is that they can last 1-3 years and can be modified as you age and don't require surgery as cheek implants do.
I would advise trying a nice round of fillers such as Radiesse and wait until you need surgery to lift and reposition the tissues.