Would a combined malar submalar implant or extended orbital rim-malar implant be best for my very concave middle face? (photos)

Dear lovely doctors, i have a very flat middle face, starting from under my eyes. I have great lateral projection on my cheek-zygomatic area already. I just greatly need middle face volume. I want the exact same results as her. Would combined malar and submalar placed right under my eyes give me this results or do i have to get orbital rim implants extended to the malar region, and then some injections to get that delicious apple - cheeks results ? Thanks a lot for taking the time to answer

Doctor Answers 6

Beauty with mid cheek augmentation.

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I agree that a quality augmentation of the mid cheek skeleton would be wonderful in enhancing your attractiveness and permanently. I perform this in virtually every young patient who wishes to have a more glamourous face as well as in most facial rejuvenations as well as in patients whose flat cheeks form the basis for early lower lid bags.
While not wanting to discourage you from this surgery, you should be careful what you wish for. The example you show certainly looks much better than before the surgery, even when you discount the benefit of proper photographic lighting, hair and make up.
However, you do not have to go to the opposite extreme. Her cheek fullness extends too low down her cheek, so it looks obviously surgical. Also it is partially aging as the cheek mound becomes lower with aging, and is becoming there already. If you relate the point of maximum cheek projection to the peak of brow projection they do not relate in her as they do in beautiful faces.
In other words the cheek projection in the oblique view needs to be high and the rest of the cheek contour fits in with this. It is not just what implants that are used, but the aesthetic eye of he surgeon in refining the shape of the implants when placed.
The implants you show are solid Medpor implants. Being solid, these do not fit into the contour of the underlying bone, so the result may well be overdone unless the surgeon shapes the implants once they are fixed in place. I and some other surgeons prefer using a different implant material made of coral granules, called hydroxyapatite, that the surgeon places onto the bone. The implant fits completely into the surface of your bone and the surgeon builds up the contour according to the plan formulated with your approval prior to surgery.
Shapely cheeks are beautiful but too much volume can easily happen and diminishes the result.

Malar-Submalar Augmentation for Apple Cheek Effect

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What you are seeking is augmentation of the anterior malar region that also extends onto the lateral orbital rim and into the submalar region. Ideally a custom made implant is the best way to approach this unique area of midface augmentation. But certain styles of combined malar-submalar implants can be modified to closely approximate the ideal shape. Any form of orbital rim implant does not provide enough volume to the submalar region to be effective for this type of result.

Type of malar implant?

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I will need to see better photos.  As you have described one wants to "Fill" the flat area only and the ways to do this are many; each with advantages and disadvantages. Face forward and profile photos are preferred for evaluation.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Cheek implant

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it is very difficult to comment without actually seeing you from front

it also matters what you want projection or width or both 

Harsh B. Amin, MS, MCh
India Plastic Surgeon

Would a combined malar submalar implant or extended orbital rim-malar implant be best for my very concave middle face?

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Yes, you would benefit from softer, fuller, rounder cheeks.  This look makes women more beautiful and  feminine.  While your photos are not great quality, I can see that adding fullness to the cheek area would softer your face.  If you would like to send better photos, we can evaluate them.

Better pics reqd

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Hi there. Is that you in the picture alongside the model? It would really help to have a full front and side views of your face in order to reach a conclusion about what would suit your face best. In case you have under eye hollows an extended orbitomalar implant will be better. However everyones facial structure is different and every patients needs are also different. Please consult a PS. 

Biraj Panchal, MBBS, MS, MCh
India Plastic Surgeon

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.