Can Rib Bone Be Used As Cheek Implants?

Question

If a person wants cheek implants, can part of their rib bone be used? If so, will it integrate with the actual cheekbone and become as if it was there all along? So, can this be done and would it cost more than a usual cheek augmentation? Thanks!

Frank P. Fechner, MD · Answer

It certainly can be done. But still, I am not sure of any advantages aside from the fact that it is your own bone.
Disadvantages of this rib bone for cheek augmentation include:
- seperate surgical site (chest) with its theoretical risks. We are usually not timid to use rib if truly of benefit; mostly the cartilage portion in rhinoplasty.
- possibility for resorption. The bone may change over time leading to diminished augmentation. The extent of this is totally inpredictable.
- difficulty in shaping the rib for a good anatomical fit. In fact, I think that likely two ribs may have to be fused in order to obtain the appropriate size.
Therefore, the three better options for cheek enhancement include injectable fillers, facial fat grafting and "conventional" cheek implants. They all have their pros and cons but work well.

Michael Kulick, MD, DDS · Answer

Hello
Yes, but why?
There are better options if you want to use your own tissue for a synthetic implant.  The cost is greater and the rewards may not be worth it.  But if your set on this, it can happen.  There will be some integration of your own tissue but you will also experience some absorption.  In contrast, a synthetic implant while not "you" has less of these problems.  I usually reserve using ones own tissue for this type of implant if a synthetic implant does not work or there are other factors that come into play in the decision process.

Trevor M. Born, MD · Answer

Dear Alexa,
Micro fat grafting is an excellent choice for facial contouring.  Soft tissue fillers such as Radiesse, Restylane and Sculptra can also be used for Cheek contouring.
With Warm Regards,
Trevor M Born MD

Steven J. Pearlman, MD, FACS · Answer

Rib bone is used for a number of facial reconstructive procedures. However, it is a complex procedure to harvest and carve bone to make it look natural. It is much easier and likely more aesthetic to use a pre-formed implant made of an inert material, either silastic (silicone) or Medpor (polyethylene). These are very well tolerated by the body and come in a number of sizes and shapes that are specifically designed for this procedure.
With the new fillers, we can even enhance cheeks for 6 months to almost 2 years with no surgery at all.

Vincent N. Zubowicz, MD · Answer

Rib can be used as graft material, but for cheek implant almost never is.  I personally never have performed that operation.  Any rib graft demands a donor incision and it is painful. 
Once in place, the bone can resorb (gradually dissolve) over time. 
Regular cheek implants work quite well. They come out of a box and are easily positioned through an incision in the mouth.  My preference is Medpore, but there are other materials available.  If the patient doesn't like the result, they can be easily removed.
But the direct answer to your question is yes.

William Portuese, MD · Answer

Rib bone is not used for cheek augmentation. The rib is a short, round, cylindrical piece of cartilage that is not well-shaped at all for implantation in the cheeks. In addition, there is just not enough grafting material to use from the rib to augment the cheeks properly. Cheek augmentation is performed with synthetic Silastic implants placed up underneath the upper gingival gum line and placed over the maxillary bone. These are relatively easy to insert and remove if needed, and is completely reversible. Harvesting of rib always runs the risk of getting a pneumothorax, and is ill-advised for cheek implants.

Christopher L. Hess, MD · Answer

There have been a lot of tissues used for cheek augmentation.  However, bone is not typically one of them.  The reason is that bone needs blood supply.  Bone that is taken as a graft has no blood supply and must get it from the tissue it is placed in to.  This can be variable.  In addition, if it does get blood it can still be reabsorbed by the body.  This will result in asymmetry as assuredly but sides will reabsorb differently.
Synthetics are much more predictable for bony augmentation.  However, it's important to remember that soft tissue augmentation is equally or more important.

Harrison C. Putman III, MD (retired) · Answer

I feel that rib bone has very little to offer except in some reconstructive cases. Better options are anatomic style alloplastic implants ( size and shape matter most, as well as symmetry) and fat transfer (may need more than 1 procedure). I do not recommend permanent fillers although these are available in Canada. If the problem is ptotic cheeks a cheek/ midface lift is an alternative.

Richard W. Fleming, MD (retired) · Answer

Rib bone can be used for cheek augmentation, but there is no reason to use this material. Yes, this procedure would cost a lot more than the many better procedures mentioned by the other physicians responding to your question.

Andres Gantous, MD - Account Suspended · Answer

Dear Alexa,
Rib cartilage and bone is a great grafting choice for many procedures, but I would not recommend using it for cheek augmentation. It would be hard to  carve and shape the bone or the cartilage to the desired form and obtain good symmetry between sites. It would have to be rigidly fixed to your cheek bone to try to prevent resorption. All this would make the operation quite complex and probably expensive. I would suggest going with Medpore or silicone implants which work extremely well. Good luck!
Dr. Gantous

Can Rib Bone Be Used As Cheek Implants?

Answers (10)

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