Should I get malar or submalar cheek implants? (Photo)

Question

I have always had a flat face and I am generally OK with that, but my cheeks now concave as I am getting older. It is more significant on my right side than on my left and bothers me the most when I look at myself in a semi-profile. I am not interested in having humungous cheekbones. I also do not want to use fillers, I want a permanent solution. Would implants fix this asymmetry, and can implants add subtle volume in the areas I outlined in my attached pictures, if so, which type of implant?

Barry L. Eppley, MD, DMD · Answer

The area you have outlined on your cheeks is the submalar region. This sits right below the prominence of the cheek bone. (malar region) Cheek concavity results from loss of soft tissue volume not bone loss. At the least you need submalar implants and the use of a combined submalar-malar implant, if not too big, would create the greatest amount of cheek tissue lift.

David C. Mabrie, MD · Answer

Hi Feronzies -

Thanks for your question! The photos are great. Seeing your cheeks from different angles helps a lot.

Would implants be a good solution for your case? Well, that all
depends on what your goals are.

If your goal is simply to remove the diagonal indentation on your left
cheek, this can be accomplished with a malar implant. But, if your goal is broader than that, and you want your features to look more defined and
strengthened overall, I’d recommend using fillers instead.

Why? Three reasons.You have more control over your results. Fillers can be
easily modified or reversed whenever you want. Let’s say you have a look you’re
going for now that fits where you’re at in life. But when you get older, your
face keeps changing along with you and your tastes. This requires different
levels of augmentation, and one implant isn’t going to take care of that
forever. In fact, it might even be a hindrance to your face in the long run.
(Which brings me to my next point.)Fillers are less risky. Implants are useful, but they
come with a larger list of possible side effects and complications. With fillers, you’ll see your results within a day. With malar
implants, you’ll see results about three to six months later.

Again, this is all about your personal goals. Remember
- the clearer you are about the overall changes you would like to make, the better.

Hope this has helped. Good luck in your research!

Stay Beautiful,

Dr. Mabrie

George Orloff, MD, FACS · Answer

Great question!  Your concern is a very common issue as we age.  As time continues to tick we will continue to lose volume in this area (and others).  The key to addressing this area is making it look good now and in the future.  Whatever is done in this area needs to fit and enhance your facial features. Cheek implants are a permanent solution but you want to make sure the outline is not visible and the area transitions nicely with your other features.  If you were adamant about implants,I would recommend small or medium combined submalar implants that provide a smoother more natural transition.  I emphasize going smaller and not larger in implant size. It is difficult to correct asymmetry with implants alone.I recommend reconsidering fillers as an option or at least try.  Fillers are the most common tool used for this type of issue. You can correct asymmetry and increase the fullness over time. You can see what type of fullness you like best.  If you do not like the fullness, it will go away or you can get injections to dissolve the material (depending on what you use).  Subtle volume is best treated with fillers.  Fillers allow for gradual improvement and change. Lastly, fillers provide a method for you to visualize the look an implant gives you before you commit to surgery.  You also look to be a great candidate for Sculptra a longer lasting filler option which is great for a natural subtle volume change.

William Portuese, MD · Answer

Cheek implants are placed for patients who have a weak and recessive maxilla along with a flat cheek profile. The area of the circle described in the photographs represents malar augmentation, not sub-malar augmentation. Cheek implants are manufactured in a variety of sizes, thicknesses and shapes, and are inserted through an intra-oral approach under a brief general anesthetic as an outpatient surgical procedure.  Digital computer imaging can be helpful to see with cheek profile might look like. For many examples, please see link and the video below

Richard W. Fleming, MD (retired) · Answer

Malar or Submalar Cheek Implants. Combination malar and submalar silicone implants will augment your cheeks and improve the cheek contour. The implants can be modified at the time of surgery to reduce the asymmetry.

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

Hi, I have performed many facial shaping procedures, over the past 30 years, using dermal fillers or facial implants (cheeks, chin).  From the photos, your cheeks are flat
anteriorly (in the front), the chin is weak and there is excess facial and neck fat which combine
to create a rectangular shaped face.   Following the beauty principles
outlined in my book, on face and body beauty, 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 using a dermal filler
(I prefer Restylane Lyft) or with cheek implants for a permanent enhancement
will create full, round cheeks anteriorly that will feminize the entire face.  I would combine liposuction to further shape the face and neck.  There are hundreds of different sizes, shapes and thicknesses of cheek implants, so be very sure that you select a surgeon that understands and follows the proper aesthetics for creating full, round, feminine cheeks.  Cheeks that look too big, too wide or too thin do not feminize the face.  Similarly, a small circular cheek implant placed where you indicated would not fill out the concave section of your cheeks but magnify its presence. When the chin is weak, this creates an imbalance making the nose appear
larger, the mid face top heavy and the lower face appear shorter which
de-emphasizes the shape and fullness of the lips.  Chin augmentation,
using a chin implant, will add projection to the chin creating harmony and
balance to the lower face.  I have found placing a silastic chin implant through
a small, curved, incisions under the chin to be very safe, quick, highly
effective and far less invasive than a sliding genioplasty that requires bone
cuts with placement of screws and metal plates.

Hope
this helps.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

Cheek implants are pretty
straightforward to put in. A small incision is made under the upper lip and a
preselected shape is put on the malar bone. There are cheek implants that
adhere to the bone so typically no screws are used. Cheek implants are made of
several material but the most common is silicone. They are permanent unlike
injectible fillers. They are also easily removed if you don’t like them or they
get infected. The risk of complications is low <1% in good hands. The cost
is around $4500-5500. Before and afters can be seen at my office. Most cheek implant
patients choose not to be on websites.

Best,

Dr.S.

Should I get malar or submalar cheek implants? (Photo)

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