Extra small malar implant size? At the final decision stage

Thank you for your pictures.  I would not recommend any addition volume for your cheek.  I definitely would not proceed with an implant.  

If you are unsure of the aesthetic result of a permanent procedure, and if a temporary option is available, it's best to try that first.Radiesse is a nice, long acting filler that allows you to 'try out' your prospective new appearance.  

Given your facial type what you are seeking is anterior malar/lateral infraorbital augmentation, not true or traditional cheek augmentation. This does need a small implant but its positioning and shape is critical otherwise you will end up with increased malar width when what you want is increases anterior malar projection.

 Cheek implants are manufactured in a variety of sizes(small, medium, large) and a variety of shapes( malar, sub--malar, and combined). They can also be custom carved depending upon the patient's unique anatomical features. Cheek implants are  placed over the maxilla and cheek area when  it has a flat appearance. The size and shape of the implants are determined at the time of consultation since the cheeks and the implants are three-dimensional.

If you use synthetic fillers. Once you determine how much volume you want you will then have to keep adding fillers to maintain the volume. Or you will have wait for the volume to go to place the cheek implants. An alternative is fat transfer which is permanent and can be added as gradually as you like until you reach your desired result.

  Hi, I suspect but would have to verify this with a full smiling photo that much of the anterior cheek (in the front) is excess fatty tissue and not your actual cheekbone.  Pressing this fat away, during the consultation, would reveal the true cheekbone shape.  For a woman's face to be heart-shaped, which is perceived as feminine and naturally attractive, the front portion of the cheeks should be full and round.  However, this does not mean that large, thick cheek implants should be used.  I have performed many cheek augmentations using cheek implants for over 25 years and remove excess fatty tissue over the anterior cheek when it is present.  Using a very small (not sure if that means thin or narrow or both) will likely add angularity to the face which is a masculinizing characteristic and as such should be avoided on a female face.  Lastly, silastic implant are a texture that does lend itself to modifications over the body of the implant.  Doing so creates divots and ruins the curvature of the implant.  Hope this helps.

It is very difficult,especially for an inexperienced individual, to judge the proper size of a malar implant to achieve the desired result. Even after many years of experience I use temporary implants provided by the manufacturers before pacing the selected implant. I agree that being conservative is always better.

Cheek implants come in small sizes and I frequently will "whittle" them down to the most appropriate size for the patient.  If you are still not sure, try injections that last for a year to get a better feel for what you want.  All the best,