Cheek Implants - Sutured or Screwed?

I have been performing Cheek Implant surgery for over 20 years here in Beverly Hills and do not use either screws nor sutures to hold the Cheek Implants in position. If you use soft silastic Cheek Implants, the screws would depress the Cheek Implant creating a dimple. Because the Cheek Implant could still rotate around a single screw point of fixation like a pin wheel, two screws and fixation points would be required. That means two dimples. Because the Cheek Implants are placed directly on top of the bone, there's nothing to suture the implant to unless the plastic and cosmetic surgeon wants to try and sew the lower edge of the Cheek Implant to the internal soft tissues below the cheek. When I do Cheek Augmentation and Enhancement with Cheek Implants, I meticulously close all the tissue layers through which the Cheek Implant is placed. This leaves no room for the Cheek Implant to move. I require all Cheek Implant, Chin Implant and Rhinoplasty patients to sleep on U shaped pillows for one month post surgery to avoid putting pressure on the implants or the nose. I also instruct all implant patients not to touch or manipulate the implants for one month. After a month the implants are secure and patients can resume normal activity.