Do cheek implants mess up the bones prior to removal?

The best way to determine how effective your described procedures would be towards a more feminized appearance is computer imaging. Based on your pictures that certainly seems to be true but it is important to see how you would interpret those facial changes.

The area you have highlighted is neither the cheek nor the paranasal area. It is in the upper maxilla under right under the infraorbital nerve. If you are trying to achieve a simultaneous Ogee curve enhancement with augmentation of the upper maxilla that would require a custom implant approach...

Custom Medpor implants as you have described can be made but their manufacture will be fairly expensive to do so. In addition that is an extremely large implant which almost always turns out to be too big for any patient. How have you come to select this size cheek implant?