How long do cheekbone implants last?

Question

I've heard it's a myth that they don't last a lifetime - which is fine, but how long do they normally last for? Also I've heard mixed things about whether or not they are screwed on. A plastic surgeon recently told me that they are never screwed on and this is a myth. Is this true? Thanks!

Jason Emer, MD · Answer

Implants are a permanent option for cheek augmentation. An alternative would be fat grafting. Harvesting is important for successful fat transfer. I use gentle water-assisted harvesting to get the most viable fat to transfer. I combine with prp and sculptra to improve results. These facial fillers (voluma, restylane, juvederm) and Sculptra can be used to augment the cheeks. This will allow you to try on the look before committing to a more permanent option like implants and/or fat. See an expert for a formal evaluation. Best, Dr. Emer

William Portuese, MD · Answer

Cheekbone implants are manufactured out of solid silicone, and last a lifetime. In our practice, we do not screw them in, however we place them in a small pocket underneath periosteum through an  intra-oral approach under a brief generalized  anesthesia as an outpatient surgical procedure. Please see the link below for diagrams of the implants themselves and many before-and-after cheek implant examples

Amiya Prasad, MD - Account Suspended · Answer

Thank you for your question. You didn’t submit a photo, but ask about the longevity of cheek implants. You have done some consultation, and a plastic surgeon answered whether or not implants are screwed in, and the plastic surgeon said they’re never screwed in and that was a myth. I can understand your confusion.
I can help you understand my current approach to the world of cheek augmentation. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Cheek augmentation as part of facial rejuvenation is something I have worked on for my entire career, everything from placement of cheek implants, fat grafting as well as fillers. I’ll tell you about my current approach to help you understand the thinking and how I evolved.
When you do these types of consultations, you are going to be subjected to the biases of the practitioner. For example, dermatologists typically don’t do surgical cheek implants, so often, if you only go to a dermatologist, you’re going to get offered a lot of different types of filler options. When you go to plastic surgeons, even if they do some fillers, they may lean towards doing surgical implants, so will naturally give you a perspective on the benefits of surgical implants. I’ll tell you first from the cosmetic surgeon’s perspective as how I evolved from what I was doing prior, to what I’m doing now.
Often patients who came who are a little older were frustrated with getting fillers placed into their cheeks. The cheek volume became strangely doughy looking and not well defined. I explained at that time when your skin and soft tissue are loose, you can’t put that much filler in your face without it sagging. It became part of my routine when putting cheek implant I wouldn’t do it in isolation, but with a facelift procedure. That way, the cheek volume was restored at the structural level on the bone structure. That’s a good solution which worked very well.
About the question of whether or not cheek implants are screwed in, with due respect to the plastic surgeon colleague, yes, it is routine to screw in a cheek implant with a titanium screw. I don’t know why that would be perceived as a myth. One of the early approaches to doing cheek implants, and still a valid approach was to use a suture to pass through an external part of the skin, and tied over a bolster so the pocket of the implant would over several days close down, then you take the stitch out. With titanium screws, you can fixate it more predictably in my opinion, so they are more stable.
One of the things very important to understand,  which the longevity question exposes, is although the implant can be in place for many years, your face changes: bone volume, fat, and soft tissue overlying all change. One thing that has evolved in my practice is when I see someone who has reasonably good skin quality and tone, is an alternative to cheek implant placement called structural volumizing using long lasting fillers. Long lasting fillers are thicker and are designed to last longer such as Juvederm Ultra Plus or Juvederm Voluma. It really has transformed my approach to helping my patients. As a surgeon, I can do both the injectables as well as surgery. but when I look at the practicality and the controllability, I’m doing a lot more placement of filler using the technique of structural volumizing, which is different from what I was describing earlier.
Most doctors, including dermatologists, place a filler right below the skin level, and try to enhance through molding of the material under the skin to try to create the illusion of structure. Structural volumizing is the technique that involves placement at the bone level. It really helps correct what is the underlying issue which is bone loss. With structural volumizing, I’m able to control volume very well, place at different areas of the cheek in a way I can customize, and I’m actually able to try to maximize symmetry in the face that is always asymmetric. The procedure takes only a few minutes to do as opposed to placement of the cheek implant in the operating room.
With this kind of solution, you can adjust what you do as the patient gets older and deals with all the other factors affecting cheek volume. People go on different diets, lose weight for a variety of reasons, so it can be a customized as things change in addition to normal facial changing.
My thinking would be is if you wanted to have a solution for the cheek, but you can place the material in the chin, jawline, and jaw angle to create the effect of a facelift, if not one step beyond based on the type of anatomy and age of the patient. There are a lot more opportunities to do these things in a customized way, and without going into the operating room.
I think I would encourage you to pursue more research and meet more doctors to learn more about structural volumizing as I described it. I think you’ll find yourself gravitating towards doing the injectables with this technique rather than commit to a facial implant. Again, there’s nothing wrong with facial implants, and I’m very proud of the ones I’ve done, but I think now we have a lot more options, and we want to always hear what is right for the patient, and try to solve the issue in the most practical, safest, and predictable way possible.I hope that was helpful, I wish you the best of luck, and thank you for your question.

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

Hi, I have performed many Cheek Augmentations, using silastic cheek implants, for over 30 years and they do indeed last a lifetime.  The solid, yet soft silastic will not dissolve and remains the "gold standard" for natural looking cheek augmentation.  
  Following my facial beauty principles, 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 or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.
  I have placed silastic cheek implants for 30 years in military, SWAT, LE, professional fighters, as well as actors and many regular people who are active.  When placed below the covering of the bone and when the layers of the cheek are closed from the inside out, there is no need for fixation screws or sutures in my humble opinion.  I do ask that all my cheek implant and chin implant patients sleep on a U-shaped pillow for 1 month following the surgery.  In addition, I have had the opportunity on numerous occasions to replace silastic cheek implants (placed by others) that had been screwed into the cheek bone.  During the replacement it was evident that the metal screws pushed right through the soft implant as it was tightened down on the hard cheek bone.  Which makes perfect sense.  So in the long run, these fixation methods alone are no guarantee that the implant won't move.  Proper placement, proper implant pocket creation and meticulous closure of all the tissues layers is what is required in my humble opinion.
Hope this helps.

How long do cheekbone implants last?

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