Flat, Masculine Cheeks - Am I a Candidate for Cheek Implants?

I feel like my cheeks are flat and lend me a masculine appearance. I am interested in getting cheek implants. I have attached two pictures of my face, as well as two illustrations as to what my ideal cheeks would be. I understand that there are limitations based on my facial structure, but do you think I could get similar results? As far as cosmetic surgery, do you think that cheek implants would make the greatest improvement in regard to my level of attractiveness?

Doctor Answers 12

Flat, Masculine Cheeks

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You do have flat cheeks, but they are not macculine. It is reasonable for you to want to increase cheek projection and contour, which will best be achieved with permanent cheek implants. In the hands of an experienced surgeon it is a predictable satisfying procedure.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Cheek Implants vs. Fat Grafting

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acial Implants for facial bone augmentation

A wide variety of facial implants are currently available for the enhancement of the skeletal elements of facial aesthetics. The most commonly used facial implants are used to enhance the profile of the chin and the cheeks. Facial implants very widely not only in shape and style, but also in terms of the materials from which they are fabricated.

My preference is to use structural fat grafting, as much as possible, to enhance facial features. In many cases, the need for a solid implant can be eliminated by the careful and meticulous grafting of a patient's own fat. While the incidence of complications with facial implants is not high, certain problems may develop which require implant removal including infection and implant migration. Bone resorption (bone loss) has also been reported below solid facial implants. Neither of these problems are an issue with structural fat grafting.

The only setting in which I currently use a solid facial implant is for chin implant augmentation. Some patients with a 'weak' chin profile can be adequately improved by structural fat grafting alone. However, when the chin protrusion needs to be enhanced by a half centimeter or more, a chin implant is absolutely required. I prefer to use a soft, flexible, anatomic chin implant that conservatively enhances the anterior projection of the chin in profile. The chin implant is placed through an incision hidden underneath the chin, an area where many people already have a scar from a fall in childhood.

Moderate enhancement of chin projection in appropriate patients can dramatically enhance the profile, in a manner that is completely natural-appearing. It is remarkable how increasing chin prominence in some patients will reduce the apparent prominence of the nose, and restore an overall sense of harmony and balance to facial features.

For enhancement of the cheek bone area, I rely exclusively on structural fat grafting. Careful and meticulous fat grafting not only avoids some of the potential complications of solid cheek implants, but it also allows more precise 'customization' of the aesthetic improvement that can be obtained for each individual patient. It is also my opinion that structural fat grafting produces a more natural-appearing enhancement of the cheek area than what is generally achieved through the placement of solid implants over the cheekbone.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Candidate for cheek implants

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Cheek implants are performed on patients who would like an augmentation of the malar or submalar area.  The implants are made of silastic plastic and inserted through an incision in the mouth above the upper teeth and placed directly over the bone and under the muscle.  They augment a flat cheek area and rejuvenate the lower cheek area by volumetric augmentation.  The implants come in both malar and submalar shapes and they come in many different sizes.  Determining which implant and size is made at the time of consultation.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Cheek Enhancement with Silicone Implants or Filler Injections

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Hi 9539anon,

Several cosmetic options are available to improve volume loss in the cheeks or midface. Volume loss is a natural progression seen with facial aging, or present at young age due to inadequate bone structure. Midface volume loss may also be seen earlier with genetic predisposition, medical conditions, severe weight changes, or medications too.

Treatment obviously is to add volume, typically. Injectable fillers with hyaluronic acid, Restylane, or Juvederm may be appropriate. Alternatively, longer acting facial fillers such as Radiesse or Sculptra provide longer-term improvement of the cheeks. All these injections are office procedures. 

Other options include fat injections, which have been used for decades for facial rejuvenation. Lastly, cosmetic surgery with a silicone implant or midface lift may be more appropriate in selected patients. Silicone cheek implants are a good option for permanent cheek enhancement.

There isn't one best treatment for facial plastic surgery procedures. Only after a comprehensive evaluation by a plastic surgeon specialist can he/she help determine appropriate options for you for natural cheek enhancement. Best of luck.

Dr. Chaboki

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Cheek Implants or Fillers?

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Yes, your cheeks could be a bit more rounded and full anteriorly.  You can use fillers like Perlane or Radiesse initially to create the Cheek Augmentation to see if you like it before using Cheek Implants for a permanent correction.  I use silastic Cheek Implants and not those made of Gortex or Medpore, but that's MHO.  There is an aesthetic way to compare your facial features to the aesthetically ideal.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Permanent Cheek Implants vs. Temporary Cheek Injectable Fillers

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For permanent cheek augmentation and the best overall effect, an implant is the best choice. If you are uncertain as to whether cheek implant surgery is for you, then a trial of injectable fillers is worthwhile. Be aware, however, that injectable fillers and cheek implants may not  create exactly the same look as implants have a very well defined shape where as fillers create more of less-defined mass effect. When considering cheek implants it is important to realize that there are different styles of cheek implants that accentuate subtle but different areas of the cheek. Selecting the right cheek implant  and size is critical as the main reasons for cheek implant revision is improper implant selection and inadequate sizing. 

Dip your toe in with fillers first

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I agree with one of the other surgeons that mentioned that implants are now almost obsolete.  The change you desire is increased soft tissue projection in your cheeks (similar to the models you have posted).  The solution would not be to add to the deep bony structure, but rather to add to the soft tissue structure.  

Furthermore, in the cheek/malar area there are various options other than implants that are not as invasive (incisions) or carry lifetime risks (infection, bone resorption, displacement).  These options include: fillers, sculptra, fat transfer.

I would suggest starting with a syringe or two of hyaluronic acid gel filler (Juvederm, Restylane, Perlane).  This will give you about a year of improvement, and then you could make the decision to have more permanent fat transfer done, or just continue with non surgical filler injections.

Good luck!

Tanuj Nakra, MD, FACS
Austin Oculoplastic Surgeon

Cheek Implants vs Radiesse

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Longer lasting fillers such as Radiesse have many advantages over cheek implants. One obvious advantage is that surgery is not required. Another is that you can get either a rapid or a gradual correction depending upon how many syringes you have injected and you can decide as you go exactly how much correction looks good. Another advantage of fillers that I frequently see is cheek implants may no longer look good in an aging face as it changes over the years. Touch up treatments for fillers over the years are constantly being modified to fit the changing face. Radiesse reportedly lasts 12 to 15 months. A booster injection 3 months after the initial injection will usually prolong the duration of Radiesse to 15 to 18 months.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.4 out of 5 stars 13 reviews

Flat, underdeveloped cheeks--what to do?

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Your cheeks are underdeveloped and this is not as attractive to women as full cheeks. The best way to correct this is with cheek implants rather than fillers which have to be repeated every year or two and don't give as much correction as implants. See an experienced surgeon for the best results.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Juvederm works for upper cheek fullness.

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You do not look masculine at all, but fuller cheeks would look good on you.  I personally feel that cheekbone implants are almost obsolete.  You can get this result more safely, and without surgery, with skillfully injected fillers. 

Radiesse is great injected deeply, against the bone.  For superficial contouring, we use Juvederm Ultra Plus.

The results are very long lasting.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.