Contour is Too Prominent - Malar Augmentation Reduction Options? (Photo)

Question

Hi, I am currently 7 months post-op and wanted to ask what options may be available to reduce hydroxyapatite malar augmentation in the cheek area. I am concerned that the current cheekbone contour appears too prominent and not harmonious, and I would like to know whether this material can be conservatively reduced, partially removed, or otherwise reshaped. I would also appreciate your thoughts on the risks, limitations, and whether imaging or an in-person evaluation would be needed. Thank you.

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your concerns and photo. At 7 months post-op, your hydroxyapatite malar augmentation is already fairly well integrated with the surrounding tissue, which is why adjustments can be a bit more complex than immediately post-surgery.

Here’s a breakdown of what’s generally possible:

Conservative Reshaping or Reduction – Some surgeons are able to carefully contour or shave down hydroxyapatite using specialized instruments. This can reduce prominence while keeping the implant largely intact. Precision is key to avoid asymmetry or irregular edges.
Partial Removal – If the projection is more than desired, it’s possible to partially remove or thin the material. This is usually done surgically and may require local or general anesthesia depending on the extent. Complete removal can be more challenging once the material has fully integrated.
Non-Surgical Adjustments – Unlike soft fillers, hydroxyapatite is hard to adjust non-surgically. There isn’t a reliable method to “dissolve” it. Some patients explore dermal fillers or fat grafting around the area to camouflage contour issues, but this is more of a masking approach than true reduction.

Risks and Considerations:

Irregular contouring if material is removed unevenly
Minor asymmetry between sides
Swelling, bruising, or temporary numbness
Rare risk of infection or delayed healing

Imaging or Evaluation:

A CT scan or 3D imaging is often helpful to assess the implant thickness and integration before any intervention.
An in-person assessment is strongly recommended to determine how much can safely be reduced and to plan the best approach.

In short, hydroxyapatite can be reshaped or partially reduced, but it requires careful planning and precision. Complete non-surgical reduction is not feasible, and results will depend on the degree of integration and your anatomy.

Zoran Potparic, MD · Answer

HA has tendency to integrate and partially impregnate with new bone, what makes reduction similar to bone reduction. You should talk to your surgeon or consult another, experienced board certified plastic surgeon, possibly with craniofacial background, about reduction/shaping. Good luck.

Jeffrey H. Spiegel, MD · Answer

Sure  - this material can be fully or partially removed or reshaped. We'd do it through the inside of the mouth.

Contour is Too Prominent - Malar Augmentation Reduction Options? (Photo)

Answers (3)

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