Would cheek implants or fat graft be the right solution for my mid face, and would there be long term effects? (Photo)

I have always had a slightly flat face, which reveals my large lower cheeks (buccal fat) and jaws. Which kind of solution would you suggest to increase projection in this area? As for the long term effects, I'm worried about the "take" of fat grafting and even more concerned about the long term behavior of implants. What long-term side effects due to implants have you seen in your patients? (ie infection, immune rejection, shifting, visibility of outline)

Doctor Answers 6

Nonsurgical Treatment for Cheek Augmentation

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I do not recommend cheek implants or fat transfer initially.  Since you have questions and concerns, understandably, I recommend you undergo injections of either Perlane or Voluma initially.  These products will provide a beautiful result in the hands of an expert experienced injector.  The result is temporary and is reversible if you do not find the result pleasing.  Following this treatment, you may decide to undergo fat transfer.  Again, a Board Certified Plastic Surgeon with experience and skill in fat injections will provide the optimal result.  There are risks with any procedure of asymmetry or infection, although these risks are low.  You may also try Botox injections in the masseter (lower jaw) to relax the lower cheek area.
Thank you.

Louisville Plastic Surgeon
4.7 out of 5 stars 55 reviews

Cheek implants for facial augmentation

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Small Silastic cheek implants placed  through and Intra-oral approach directly over the maxilla are all that's needed to  augment the flat cheek area. Very rarely do we ever see them shift, migrate, get an infection, or develop a serous fluid pocket around the implant. Cheek implants give a very predictable result. For more information, diagrams and  our cheek implant photo gallery, please see link below

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

Would cheek implants or fat graft be the right solution for my mid face, and would there be long term effects?

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    I think that either is reasonable, and you just need to choose based upon the issues you have brought to light.

Kenneth Hughes, MD

Los Angeles, CA

Cheek augmentation

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All approaches work, however all of them have their potential drawbacks. When you smile your cheeks  have much more prominence. Would you want them to look overly prominent when you smile? You would have to be seen in person for a proper evaluation.

In over 35 years of doing cheek implants I have, of course, seen problems. With 15 years of fat transfer, I have also seen problems. No problem has been severe enough to cause any permanent damage. Both procedures have some degree of reversibility, especially the cheek implants. If the cheek  implants do not give a problem within the first six months, they should not be a problem for most of your life. In later years if you have facial wasting the implants might be more noticeable. Treatment can always be done then. Fat can grow or shrink but carries the versatility of being touched up or extracted as needed. 

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon

Cheek Implants, Fat Grafting, and Buccal Fat Reduction

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Thank you for the questions and the photos. You bring up some important issues with respect to the cheek contour and common procedures.  Fat grafting, when it works out perfectly, is a fantastic procedure.  However, as you suggested, the "take" is not always 100% and may be different between sides.  Cheek implants are much more predictable.  The additional advantages of implants is that they are a definied shape, and are removable if you change your mind later.  The implants are made of a silicone-based plastic and are biologically inert.  They are considered safe, and, in my practice, have been a great option for patients.  Shifting or movement of the implants is possible but rare. Lastly, you bring up an excellent point about the contour between the upper cheek and lower cheek (buccal fat).  In some cases, adding volume to a flat upper cheek can be enhanced by removing a small amount of fat from the lower cheek. This procedure, called buccal fat reduction (cheek slimming) is done through a small incision in the mouth and can be performed at the same time as either of the above techniques for the upper cheek.  Best of luck moving forward!

Would cheek implants or fat graft be the right solution for my mid face, and would there be long term effects?

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Yes, you are a candidate for cheek augmentation with an implant or fillers.  Your cheek area is flat, so you may benefit from the implants.  Soft, round cheeks give women a more feminine look.  The incision is on the inside of the mouth, so there is no obvious surgical incision.

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

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.