Suitable cheek implant and rhinoplasty candidate?

Question

I am unhappy with the lack of shape and narrowness of my face -could cheek implants address this? What shape implants would be recommended? I also dislike the slight sagging /folds near my mouth, would it also address this? Second, I was thinking of getting rhinoplasty as my nose has a bulbous end / a bump on the ridge. Is there anywhere in either Brussels (or elsewhere that's more affordable? Turkey?) that people recommend for these procedure? What key questions should I ask surgeons? Thanks!

Alejandro Nogueira, MD · Answer

To begin with, cheek implants do not exist, the cheek tissues are not suited to cope with the presence of alloplastic materials. Maybe you refer to the cheekbone or malar implants, desiged for and aiming to enhance and augment the prominent of the malar bone (inferior-outer quadrant of the eye orbit) when it is flat; well, you are a very good candidate for cheekbone implants; I agree your face is too linear and elongated, you'd benefit from a more hear shaped look; cheekbone implants are stable, safe and an be inserted via endobuccal approach without external visible scars.Regarding your nose, I don't apply a diagnosis of bulbous, it is not; you have a moderately oversized tip, but is not bulbous or a complicated one; you are an indeal candidate for the cheapest and easiest modality of rhinoplasty, via endonasal without external scars, a basic reductive rhinoplasty to: shave the dorsal bump, osteotomies to close the roof, narrow the nasal pyramid and prevent the dreadful inverted V deformity, narrow the tip and also deproject the tip which currently is too long. Finally, I'd recommend and multidimensional reduction genioplasty (if within your budget) to reduce the vertical height and the horizontal width of your chin; it seems to me the anterior projection is fine in your case, however this could be discussed after viewing the side profile. With the two-dimensional reduction genioplasty you'd achieve the perfect oval and heart shaped feminization facial balance and really a brand new face if cojoined with the rhinoplasty and the cheekbone implants; do consider seriously doing such three-pack. Difficulty, if done them three, 9 out of 10 scale in facial surgery, due to the highly demanding requirements of calibracion, good anatomical and aesthetic judgement and technical skills from your surgeon; very very few surgeons would be able to perform successfully such major facial overhaul, however it is a very safe procedure in expert hands. May you wish an affordable cost with the best experience possible and highest medical and hospital safety do consider travelling abroad, among other destinations in Spain you may find the technical skills in facial plastic surgery which are very rarely found elsewhere, including your motherland. If you wish better grounded opinion well lit, focused and standard images have to be assessed: frontal, both lateral and both oblique views, also underneath the nostrils.
Feel free to request any additional information from me.

Zoran Potparic, MD · Answer

Based on your photos nose surgery would definitely be a good solution. I am not surge about chin augmentation because there is no good profile view to evaluate nose-lip-chin relationship. In-person consultation with a board certified plastic surgeon with good reputation in rhinoplasty would help. Good luck.

Bianca Knoll, MD · Answer

thank you for posting your question. There are different types of cheek implants that can be used. They vary in the amount of projection, width and extension towards the zygomatic arch. They can be shaped intraoperatively to the individual anatomy as well, so that they match perfectly your contour. Most commonly they are secured with screws. Depending on the projection that is being used, you will receive a lift of your midface area. One of the feared complications is infection of the implant, since they are most commonly inserted from the inside of the mouth. We like to use a pretty rigorous regime preop and during the surgery in order to allow  a smooth healing phase. The recovery time does not take too long. Both procedures, the rhinoplasty and the cheek augmentation can be performed together.I hope this was somewhat helpful.Kind regards

Paul Carniol, MD · Answer

Thanks for asking this question.  These are common concerns.  It is possible to enhance your cheek bone region with certain fillers and/or implants.  Currently more people favor fillers as this does not require surgery.  
Be sure to see a physician who has experience with midface/cheek bone enhancement

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

Hi, I have performed many facial shaping procedures using dermal fillers, facial implants (cheek, chin, lips), liposuction and/or facelifts for over 30 years.  From the photos, your cheeks are very flat in the front, there is excess fat in the mid face, the chin is quite weak, the nose has a dorsal hump with a nasal tip that is a wide and over-projected (sticks too far off of the face).  These combine to create an elongated, rectangularly shaped face.  
 Following my facial beauty principles that I have developed over the past 30 years, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler (temporary augmentation) or using silastic cheek implants (I prefer using comet shaped) for a permanent enhancement will create full, round cheeks that will feminize the entire face.
 I have performed many Chin Augmentations using chin implants for over 30 years.    When the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.  I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick, highly effective and far less invasive than a sliding genioplasty.  I perform chin implant surgery in 30 minutes or less, often using a local anesthetic alone.  In my opinion, you are a good candidate for chin implant surgery.
 Finally, a Closed Rhinoplasty can reduce the dorsal hump and refine the nasal tip (thin and slightly reduce the over-projected tip).
Hope this helps.

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