What Are the Advantages and Drawbacks of Using Hydroxy Apatite Paste on a Malar Augmentation over a Silastic Implant? (photo)

I'm considering having a cheekbone augmentation but I don't like the look of most malar implants I've seen. They can be the wrong size, they can be in the wrong place or in the wrong angle, they can migrate... they can also show through the skin. I'm more open to the idea of adding volume to the zygomatic bone with hydroxy apatite paste for a more controllable result.

Doctor Answers 6

Cheek Implant vs Radiesse Filler

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I would certainly recommend placing Radiesse initially to make sure you are happy with volume and location of the augmentation.  Radiesse works very well to provide enhancement in this area and is long lasting, typically 12-18 months.  If you were happy with the result with Radiesse augmentation than you could continue to have this performed on a regular basis or you could decide to go with a silastic malar implant at a later date.  Best Regards,

Jacque P. LeBeau, MD

LeBeau Clinic

Pensacola Facial Plastic Surgeon

Top 3 benefits of Non-Surgical Cheek Augmentation with Fillers

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In my San Francisco office I prefer non-surgical cheek bone (Malar) Augmentation to surgery.  Depending on the patient's anatomy and needs, I will uses Restylane, Perlane, Artefill or Radiesse (Calcium Hydroxyl Apatite). 

Non-surgical augmentation has many advantages over surgical augmentation with a silastic implant, here are the top 3:

  1. Recovery. Recovery from non-surgical augmentation includes minimal to moderate swelling for 2-5 days. Surgical implants have moderate to severe swelling for 7-10 days.
  2. Risks/ Side Effects.  Both procedures have risks, but the risks of infection, nerve injury, and need for further surgery are much higher with surgical implants.
  3. Results! The results from injectable fillers are often better than those from implants because they can be customized and easily adjusted with the patient in an upright position in the office.  And the patient can actively participate with suggestions!

When there is severe atrophy of the midface and a very large volume is required surgical implants may be helpful. Patients will still need fillers to feather the edges in the tear trough and periorbital areas.

In general, the cheek can be a great place to have augmentation as strong cheek bones are key to the attractive face!  We have several example of non-surgical cheek augmentation in our photogallery.

Good luck!

David C. Mabrie, MD
Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 156 reviews

Radiesse vs. Implant for Cheek Augmentation

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Thank you for the great question! Calcium hydroxyapatite (also known as Radiesse) is a great option for non-surgical cheek augmentation.  In fact, for my patients who are considering implants, I often do this first so that they can "try it out."  Then, once the filler wears off, we proceed with implants. The only disadvantage of non-surgical cheek augmentation is that it has to be repeated every 9 to 12 months. As a final note, cheek implants come in different shapes and sizes -- you should be able to see these during your consultation to give you a better idea of exactly what you're looking for.  Best of luck!

What Are the Advantages and Drawbacks of Using Hydroxy Apatite Paste on a Malar Augmentation over a Silastic Implant?

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Radiesse or hydroxylapatite filler is a great option for cheek contouring but the results typically last only about 12 months and will need to be repeated. Cheek implants are available in a wide variety of shapes and sizes that suit most facial sizes and shapes. The do not often shift or appear visible through the skin. Fillers are often used initially for patients concerned about the appearance of a cheek implant since they are temporary. However, most patients will eventually opt for a permanent solution which in this case is typically silastic cheek implant. I hope this information is helpful.

Stephen Weber MD, FACS

Weber Facial Plastic Surgery

Hydroxyl Apetite v/s Implants

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There is no problem with having cheeks augmented with Hydroxylapetite paste as long as you know it is not permanent.  Properly placed "anatomical" silastic cheek implants are safe, effective, very natural in appearance and permanent.  Select a surgeon that has lots of experience placing cheek implants

Cheek implants

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Cheek implants are placed close to the bone and are anchored.  Migration, external show and other complications are possible but unlikely in expert hands.  Radiesse is fine but, as you know, is temporary.  Consult with a board-certified Facial Plastic Surgeon to assess you options.   All the best.

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.