Cheek Implant Specific Risks?

Question

for malar implants to create a chiseled look on a male face, what are the specific risks? understandably theres all the usual surgery risks of infection etc, but its specifically nerve damage that worries me. how likely a risk is paralysis or nerve damage? is it important to have a maxillofacial surgeon do the work, and what are the things to check with the doctor, and what things have you personally seen go wrong and why? sorry for all the questions, just trying to educate myself on it more!

Michael I. Echavez, MD · Answer

As with all surgery, there are several risks with cheek augmentation surgery.  The general risks of any surgery would be things like infection, swelling and bruising.  With cheek augmentation specifically, bruising is fairly unlikely, infection is possible but also unlikely and swelling is likely to happen but would be temporary.  In regards to nerve damage, the main risk is to a sensory nerve which supplies the sensation primarily to the lower cheek and upper lip.  There should be virtually no risk to damage any nerve that would cause paralysis.  Even the risk to damage the sensory nerve would be low, but it is a possibility.  

	The types of surgeons most likely to perform cheek augmentation would be facial plastic surgeons, plastic surgeons, and some maxillofacial surgeons.  I would make sure that your doctor is board certified, and try and get recommendations from people you may know.  Good luck!

Larry S. Nichter, MD, MS, FACS · Answer

Here are some of the specific cheek implant risks. Fortunately they do not occur in most patients:

	Impaired Sensation to the cheek, temporarily or permanently
	Implants can be dislodged or shifted, especially  early  after surgery.  
	With  eyelid approach retraction of the lower eyelid is possible resulting in dry eyes
	Infection which may require removal of the implant

Scott Trimas, MD · Answer

Some of the risks include infection, bleeding, scarring, numbness, nerve weakness which can be permanent, implant extrusion and migration and asymmetry, The most common problems that I have seen is disparity between the two sides of the face. Even when using the same size implants invariably there will be some difference between the two sides of the face which often requires correction with a filler or fat injections. Other side effects that I have personally seen including the edges of the implant being visible especially in someone with a thin face and also having the implant be felt inside the mouth when chewing which can be bothersome to some patients. One thing that can be tried is sculptra injections if you want a slower increase in the fullness of the cheeks without the risks of an implant. Good luck.

William Portuese, MD · Answer

Cheek implants are a very safe alternative to give a nice cheek augmentation. They will not give a chiseled look, just an overall larger cheek area. The chance of an infection after a cheek implant is rare and we do place patients on antibiotics. The chance facial nerve paralysis due to cheek implants is rare and has never happened in our practice. We have had a couple of patients who had a small area of permanent numbness over the cheek area due to local pressure on the sensory nerve itself. We have also had a couple of patients develop a fluid pocket around the implant 6 months or a year after the procedure, which just needed to be drained. The large majority of patients are extremely happy with their cheek implants and love them.

Barry L. Eppley, MD, DMD · Answer

The most significant risks of cheek implants are asymmetry and lack of getting the desired result. The risk of permanent nerve damage is very low because the nerve is easily visualized and avoided, although most patients will have some mild temporary numbness.

Francis R. Palmer, III, MD (retired) · Answer

I have and continue to perform many Cheek Augmentations with fillers (I prefer Perlane) and Cheek Implants and have done so for over 22 years. The main risk, IMHO, with having Cheek Implants is the lack of aesthetic judgement allowing the cheeks to be too large or mis-shapen. The risks of infection, implant shift and nerve injury are far less IMO but would obviously depend on the experience of the plastic and cosmetic surgeon. Be certain that the plastic and cosmetic surgeon, you select for your Cheek Implants, understands and follows the proper aesthetics of facial beauty for the creation of a chiseled, more angular and ruggedly handsome face...which is the shape desired in men.

Sheldon S. Kabaker, MD FACS (retired) · Answer

The usual risks have been well presented by the other physicians. However, based on observed cases, there is a risk for temporary weakness of a cheek or upper lip especially with the larger implants which have to be placed beneath a branch of the facial nerve which is stretched. When and if this happens , Botox therapy can be used for symmetry until the nerve function returns.

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