What Can Cause the Skin to Sag After Cheek Implants Are Removed?

I have read that cheek implant removal can cause the skin to sag. If the implants were large 4mm malar shells in the submalar zone and were in for less than a month could this occur? I am 33, is it because the muscle is lifted off the bone when they are put in and it doesn't reattach properly to the bone in the same pre op position after removal, or could the excessive swelling cause the skin to sag? I hope this won't happen to me.

Doctor Answers 2

What Can Cause the Skin to Sag After Cheek Implants Are Removed?

I have performed many cheek augmentations with cheek implants over the past 20 years and IMHO, removing the 4mm implants after 1 month would not cause any permanent tissue sag.  I would however, place some Perlane in the cheek area to create the proper aesthetic cheek shape as the tissue was settling from the implant removal.

IMO, if you would have had 5 or 6 mm implants that very in for a year or 4mm implants that were in for many years and you were over 40 years old, I would expect some significant degree of tissue sag.  The sagging btissue occurs because it has been stretched to accommodate the increased size of the cheek bone/cheek implant.  Once the implants are removed, the cheek bone does not have adequate volume to support that tissue and as a result, it sags.

Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Cheek Implant Removal Can Cause Tissue Sag Afterwards

I believe you have already answered your own question. When placing cheek implants (or any implant for that matter), the soft tissues are elevated off of the bone. The size of the implant is not that relevant (although bigger implants make it worse) as the tissues have been detached from the bone. Because cheek implants are on the side of the cliff so to speak, once their support of the soft tissues have been removed the overlying cheek tissues will sag downward more than before surgery. This is inevitable and early implant removal doesn't negate that the tissues have been detached/loosened. It is still too early to tell if when all the swelling goes away that there will be some tissue 'snapback'. But it would not be a complete surprise if it did not.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

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