27 Y/o Finally Getting Cheeks and Filler in Recessed Chin with Dr. Niamtu in VA

I want to preface this review by saying I...

I want to preface this review by saying I originally made a Pre-Op review in advance a few months ago when I scheduled the surgery. At that time I received so many negative and discouraging comments I asked the realself team to graciously rescind the post. If you're against plastic surgery or want to tell people to accept the way they look because you have a chip on your shoulder about a bad procedure you've had or something else, it's a pretty rotten idea to project that on people at this website who are looking for support. Many of us are already dealing with naysayers in our real life.

There are not enough cheek implant reviews on here or in general available on the internet, and a lot of misinformation about them. I intend to make this as detailed as my time and patience will allow, and I am more than happy to help anyone with ANY questions or clarification you may need.

Background
Despite having good malar prominence (lateral cheeks), I have had noticeably flat anterior cheek bones (submalar) along with hollowish tear troughs since I lost my initial baby-fat in childhood, which did not significantly change with any weight fluctuations. I also have a slightly recessed chin, and both of these issues were amplified by and amplifying to a very projected, "Mediterranean" nose (I am half Jewish and close to half Italian, so that may explain it!). When I underwent Rhinoplasty in 2011 I also had fat injections in my cheeks, and three succeeding injections spaced out months afterwards; and fat all quickly dissipated each time after the initial swelling went down. After the fat transfer I tried filler/restylane, which dissipated in what seemed like weeks. At that time I also had Radiesse injected into my chin but was not satisfied with the result, as I desired projection rather than lengthening and seemed to get the opposite of that. I am still on the fence about getting a chin implant so I decided this time I would have Dr. Niamtu (who is an expert with facial proportions) inject Voluma into my chin to help me make a long-term decision. The Radiesse too dissipated completely before two months was over. So I realized these method were not cost-efficient with how fast I metabolize them. Additionally, since my deficiency is in the bony areas it makes sense to use a bone-imitating material (silicone), rather than a filler which tends to be softer and better compensates for fat atrophy.

Why I chose Dr. Niamtu
See my surgeon review below.

Pre-Op Appointment
Yesterday my boyfriend/post-op caretaker and I went to meet Dr. Niamtu and Brooke (the surgical RN) to go over the details of surgery, take before pictures, and confirm what will be done. As he was at the consultation and in follow-ups, Dr. Niamtu was very thorough and patient. Brooke, the other nurses, and all of the patient coordinators (I have mostly spoken with Rachel) mirrored the same kindness as him. I cannot speak well enough of this surgeon and his staff!

Day 1- Today
*Dr. Niamtu had an observing medical resident during my procedure. I thought it was neat that I was able to be a part of someone's learning!
*Fasting- (no food or any liquids, including water) after midnight on was brutal. I made sure not to overeat last night and should have eaten and drunk more water before I went to sleep. I was so thirsty and starving in the morning. I recommend to everyone the day before general anesthesia try to eat a hearty, late-ish dinner and keep very well hydrated up until bedtime, limiting caffeine and salt.
*Schedule of events- I arrived at the office for my 8:45 appointment and left around 11:45. Another very sweet nurse (I forgot her name) did two quick x-rays around my head. Dr. Niamtu and Brooke met with me again to review everything. Then I met with the anesthesiologist, who was just as awesome as the surgeon! Every other anesthesiologist I've had to meet with has been notably unfriendly. I changed my clothes (swap all shirts/bra on top and replace it with hospital gown, as well as any bottoms with metal), and soon proceeded into the operating room to begin anesthesia. When it came to the actual IV, he put some type of numbing stuff on the hand he used which made it hurt much less, so I appreciated that. They put some kind of breathing tube down my throat to make sure I got oxygen during surgery, which did leave some scratchiness in my throat afterwards. I think I went into surgery around 9:45 and began waking up around 10:30, at which point I gradually regained my awareness. I remember saying something to Brooke about how she interrupted my "alternate reality" when she woke me up. lol
*Meds/Pain- Let me first say I have what I think is a low pain tolerance. I'm a baby. So with that said, I had a splitting headache upon waking (probably severe dehydration) and some pain/achiness in my face. I have a job where many of my clients are addicted to pain medications which I find terrifying, so I was very stubborn about taking them. I took two Tylenol about an hour after leaving the surgery center and was still in some dull pain throughout the following few hours, enough to stop me from being able to get much rest. I finally relented and took a Percocet around 5:15 tonight which helped a LOT with the pain. Lesson to be learned: Don't be a martyr. Being in pain is not conducive to recovery. I have a prescription for Vicodin for sleep and am still deciding whether or not to take it before bed.
*Bleeding- Not much bleeding. I had to gave gauze around the incisions (through the upper gums in my mouth) which were bloody for awhile. I changed them twice throughout the day (once after eating vegetarian chili, which may or may not have precipitated it but didn't last long) as there was still some blood, but the bleeding seems to have stopped as of late afternoon.
*Swelling- I am told swelling will be probably at its worst the 2nd or 3rd day after surgery. I do not have any bruising other than on my chin from the filler (which based on past experience will probably go away within the next few days). My swelling isn't nearly as bad as I expected but it's already increased since morning. My boyfriend just said he could tell my face is more swollen and that my face is "cute" because I look like a chipmunk or how I would if I gained 100 pounds. lol
*Eating/Drinking- At first my upper lip (both above and below the vermilion border) was almost entirely numb, along with the bottom part of my nose. I have to sip drinks, either from a bottle or a cup without major slurping. As I type now (8pm exactly) my upper lip is nearly entirely un-numbed. However, I have a sore jaw still and cannot open it very wide at all so my diet is going to be limited until that improves more. So far today I have very slowly eaten: vegetarian chili and vegetarian refried beans (with nutritional yeast added for flavor and extra macro- and micronutrients I'm probably missing the next few days), tomato soup (which I sipped like a drink), coconut milk yogurt, and my boyfriend just bought us both coconut milk strawberry ice cream to share after melting it in the microwave. Yum! So basically I can only eat things that I can get in my mouth a little bit at a time with a spoon pointing down, or by sipping. I am hoping to get some fruits and vegetables in my system tomorrow if I'm up to it. I bought a lot of leafy greens, roma tomatoes, low-fat salad dressing, blueberries, and some apple sauce! I am aiming on the side of higher protein during healing time.
*Teeth brushing- I bought a manual super-soft baby toothbrush. I have to be careful for awhile in lifting my upper lip to brush my teeth to avoid aggravating the incision sites. It's also just hard to raise my top lip in general right now.
*Comfort/Mobility accommodations- I was told to avoid any movements or lifting which will increase blood pressure. I am avoiding bending down as much as possible. I am a regular squatter so I'm squatting down instead when I do get something from below my waist, while keeping my head up and back straight. My boyfriend will be helping me to clean our cats' litter boxes and feeding them when I get home. I am using an awesome adjustable inflating neck pillow propped up by two pillows (this one: http://smile.amazon.com/gp/product/B0154GG7OC?psc=1&redirect=true&ref_=od_aui_detailpages00) to help keep my head up and not lean to the side on my cheeks upon sleeping and keeping a pillow under each arm. I also have two facial ice packs which I've only used a little so far. They can be heated too for later on in surgery, but unfortunately are a little big for my face (probably best for men's faces). Still useful and recommended. (http://smile.amazon.com/gp/product/B015JCW6WI?psc=1&redirect=true&ref_=od_aui_detailpages00)
*Exercise- I was told I can resume light cardio exercise in 10 days and heavy weightlifting in 4 weeks. This is my least favorite part of the surgery (exercise does a lot for my overall happiness and well-being) but realize it's temporary and necessary, and I look forward to spending more time doing sedentary activities I enjoy in the meantime.
*Chin- Other than slight asymmetry at the bottom (which is clearing up and almost certainly initial swelling from the injections) I LOVE my chin. Dr. Niamtu put a few drops in the mentolabial fold and the lower part. It's such a perfectly subtle difference my boyfriend can't even tell and Dr. Niamtu put exactly as much in as I wanted. I'm hoping it doesn't go down too much from here. I will be seriously thinking about a future chin implant at this point if the same look is possible, and am somewhat regretting not doing it simultaneously with the cheek implants.

I am uploading before pictures along with a few I took today (sorry for poor photo quality-- hotel room is not well-lit). Will do another update when I get a chance!

Day 2!

Currently late afternoon.
*Had my post-op appointment at 8am and went home today. Dr. Niamtu said my tissues were easy to cut through where some people's are more laborious, which may account to what seems like a better healing so far than I anticipated. Discussed that I'm happy with my chin and whether I can get a similar result with an implant. He says it is possible with a small one as well as to get coverage in the mentolabial fold area with the right placement.
*Numbness: My top lip is 95% un-numbed and most of my left cheek other than the very top part. My right cheek and right-bottom side of my nose is slowly un-numbing too. Kind of weird that half of my face feels different than the other, but I'm sure it's very temporary!
*Swelling- A little bit more today as predicted. Some bruising is becoming evident but not major. I walked into several crowded stores on our way home and got some funny looks, but I still didn't mind too much being in public already. I'm hoping to shower tomorrow!
*The ride home (3.5 hours) wasn't as bad as I thought it might be. No pain meds (yet? hopefully not) for the day and only took tylenol when I woke up and at lunch time thus far.

Posting more pictures!

Day 3!

Quick update
*Bought Peridex when I came home yesterday, which is a prescription antibiotic mouth rinse Dr. Niamtu wrote for me. I'm using it twice daily until... I'm not sure when (the bottle is pretty big and will last for awhile). I'll have to check on that. Gives me peace of mind to help protect from infection.
*I'm more comfortable moving around but trying not to push myself.
*The initial facial pain is starting to give way to slight bruising and feelings of tingles around the implant areas where I'm numb (which is kind of an unusual feeling, but expected!). I woke up looking like a ridiculous pumpkin (picture will follow) and my face has taken on an unusual yellow tinge (I tend to have cool undertones so it's definitely from bruising). I think soon I'll be ready for warmed packs to my face but not sure if I'll bother. I really did not like the feeling of any pressure even from the cool packs earlier so I might just let nature take its course there. Or I might use a warm washcloth instead.
*Swelling- I have a strong feeling today is the climax of it and will slowly begin going down over the next few days.
*Food/Eating- I am able to eat slightly larger bites of food today. Ate vegan mac 'n cheese (mm) with no problem this morning (yes this morning. I was starving!). Probably will be a few more days until I can get into the crunchy stuff again.
**Constipation- Hard to talk about but was a bit constipated the first two days which is not a problem I've dealt with at all in the 4.5 years since I've followed a vegan diet, so I was a bit alarmed about that. However apparently it is very common though after anesthesia, especially if you take any pain meds. Metamucil is good stuff which seems like a better alternative to traditional laxatives. I recommend using the kind you dissolve in water. Feeling better now. :D

May put a shower off until tomorrow when hopefully my face is a little less sensitive.

Found a before picture the day before surgery

Very unflattering but very accurate. Wow! Already looks weird to me. And my swelling is starting to go down today. :)

Day 4- Another quick update and new pictures taken with better camera (i.e. my boyfriend's phone!)

*CAFFEINE- I seem to be more sensitive to caffeine since surgery than before. I drank around 16 oz. of Diet Soda w/caffeine yesterday (which is typical for me) and had a somewhat scary reaction. I had some right-side chest pain for a little while, my cheeks turned very warm and pink, and I developed a very slight fever. It went away in about an hour, but I have a feeling the surgery/meds may have affected my sensitivity. So I'm going to try and stay away from caffeine until I'm done with the Prednisone/Antibiotics and more of the swelling has dissipated!
*Swelling/Feeling- Most pain is away other than occasional tinges. Now I'm just feeling tingly and still have some numbness. I can slightly smile now, but I look kind of silly when I try! Swelling is down a lot but there's still some in my lower face , so much of the definition is still not evident. I'm starting to wonder if I should have even taken this entire next week off work because I have a feeling I'll be good to go in a few days! Hopefully I won't get cabin fever. :)

Day 5- Going back to work early! And what do you think?

More pics. I took these pics upon waking. I am used to looking pretty worn down when I woke up. I'm going to try and continue sleeping on my back even when I no longer have to as it seems to really help avoid looking terrible in the morning.

I'm very happy with the results thus far. My only meandering thought is that I might want larger cheek implants (mine were medium-size submalars, which isn't tiny especially since I'm a pretty small female at just short of 5'0"). Then again at this point there is still swelling to go down so that may change once more definition is visible. Let me know if you guys have any thoughts on that!

I'm feeling pretty good and see no reason to take the rest of the week off from work. E-mailed my supervisor and decided I am going to work from home this week (my job involves traveling to client houses in addition to home-based office work).

Sleeping position, and my lips & smile is coming back!

A few things.

1) For those of you wanting cheek implants: I HIGHLY recommend going to a doctor who uses titanium screws to secure them. I don't care what they say about "pockets" or "capsules" healing around the implant (this is more common with the medpor ones, which I would beg you not to get as they're practically irreversible) -- foreign objects in your body can migrate, which is an unneedingly common complication. In addition to the aesthetic problems of migration, it is a leading cause of major infection and even rejection from your body. Mine have two titanium screws in each cheek so they're not going anywhere, and I know the other best surgeons around the country do the same (like Dr. Eppley, Dr. Slupchynskyj ). No reason to take the risk. Another issue relating to this is sleep position. To prevent migration doctors who don't screw them into your face will require you to sleep upright from anywhere between a week and a month or more, while your tissues accommodate the implant. Unless you're used to sleeping straight on your back on a U-Pillow, this will grate on you quickly. To be frank, when you aren't sleeping well nothing else matters.
With that said, I was having just this problem last night. Since I usually have zero sleep problems I found this disconcerting and did not want to resort to taking the Valium. I'm so glad I e-mailed Dr. Niamtu around 10pm last night and he responded back immediately, saying to just try to sleep on my back, "but if you can't, just sleep!" Phew. So I did that, woke up sleeping on my face, and am just fine! In fact I look even better since I'm well-rested for the first time since surgery. I still think it's ideal to sleep on one's back in general, but I'm glad to know my face won't be ruined if I don't!

2) My lips were kind of turned "inward" after the surgery from swelling which I didn't initially notice, but they seem more normal today. Woo hoo I'm not lipless anymore!

3) My smile is really coming back. I can't wait to see how a full smile will look.

This may be attributable still to residual swelling, but I feel like my face looks SO MUCH younger. I used to see lines sometimes developing on my otherwise youthful face even though I take great means to protect my skin from sun damage (I'm one of those girls who wears sunblock even when it's raining). Good facial structure goes a long way!

My lips have officially returned.

The only swelling that I think is left is almost undetectable amount along my jawline. So grateful for my quick healing and good health. So happy with these results and wish I had pursued both cheek and chin implants years ago with my nose job. I put on blush and foundation last night and felt like a beauty queen! Here's a pic of me upon waking (makeup off!). I can't decide at this point whether to pursue a chin implant later on. I guess we'll see how long this filler lasts.

1 week down! And broad facial changes that come with cheek implants

I'm hoping these are my final results because they are exactly perfect!
There is still some very slight, intermittent bruising/swelling which temporary alters my look throughout the day and is messing with my head. So I'm reminding myself to keep cool and keep on. :D

A lot of people want to know the changes cheek implants will make in their face (besides giving you more cheek projection). Here's a few things I've noticed in mine, which you may too in my photos below.
-My midface appears shorter, "cuter," and more proportionate. The middle of my face used to look a bit more long, drawn out, and wide.
-My nose looks slightly smaller, especially in the profile view.
-My overall face is softer, more heart-shaped, less severe.
- If you have a flat submalar cheek area like I did AND tear trough hollows, cheek implants alone may help to augment your tear trough area to a satisfactory degree. The hollows in my tear trough have softened by a long shot. They're not perfect, but dramatically improved from before. As they are now I do not see a need for further augmentation of that area by filler or implant.
-My eyes look more alive and expressive to me. This may have to do with the tear troughs.
-You will inevitably look younger as volume will be more concentrated at the top of your face. Also some fine lines that would sometimes show up around my mouth are much lighter now.

One week + 1 day: Numbness decreasing, facial animation increasing

My right cheek/nostril which was almost entirely numb initially has been un-numbing a bit today. I'm also able to make slightly more animate facial expressions, which brings my face *to life*.

The *color* in my face (I have pink undertones, especially in my cheeks) which I hadn't even realized had gone has returned, which actually makes a huge difference. My skin looks smoother and healthier.

I'm planning to meet up with some friends this Sunday. Excited to see how they react to my new cheeks, if at all!

I can smile a little more

I can smile a little more today. My top lip is still not fully mobile. Right side numbness still making its way out. Saw my friend today (who is also an expert nurse injector). She says my face looks fantastic and "refreshed!" :D

~2.5 weeks!

So it's been a good 2.5 weeks now. I can finally lift weights again soon woohoo!

My smile is completely recovered!!! Phew. Most of the numbness I had on the right side of my face is gone. My right cheek is still a little sensitive to touch and manipulation but I'm happily sleeping on my side/face like I used to.

Here are some recent photos. Compare them to my befores! I'm probably not at my best, but that's the point! No makeup. I'm realizing cheek implants cannot be fully appreciated if not seen in-person or some kind of 3-D view. I think you can see the difference more in the profile view than anything else. Very happy! I've gotten nothing but compliments thus far.

Still happy with the chin filler. I want it to stay forever. But some of it's already dissipated. ):

More photos and... more attention

I want to encourage everyone who seeks and wants cosmetic surgery to dismiss dissenters who tell you you're being vain for wanting to be happy with what you see in the mirror. You are not a bad person for being unhappy with the genetic lottery to which you were born. You have a right to pursue happiness in whichever way that means to you.

It's funny how this surgery was COMPLETELY 100% for me. I politely ignored many people who told me I was crazy and my face was fine as it was. And yet, I have to admit I have been getting a lot more attention from the opposite sex (which I was not hoping for nor anticipating) and more positive interactions with people in general. While this may be attributable to more confidence (I had pretty good self-esteem before though), let's be real. Being more attractive gives you a head start in almost every facet of life, and it sure is worth a pretty penny and effort to obtain. Unbelievable how such small change makes such an enormous difference!

I sent an e-mail to Dr. Niamtu today with updated pictures and let him know I am happy to be a good reference for him. If anyone would like to know more please message me. Even though it's a considerable distance I will likely go back to him if/when I pursue a chin implant. There are some fantastic doctors who are closer to me but I don't think you can go much better than him!

An update with pictures, but...

Well it's been over two months now and I've had several requests for updates. Honestly not much has changed at this point! I have some personal things going on which has been leading to consistent sleep deprivation, and let me tell you that makes a HUGE difference in your face. So keep in mind these pictures are me with an average of 4 hours sleep/night. One thing I think I've noticed, although it may be me being neurotic, is that my cheeks actually look deflated when I'm dehydrated and/or very tired. It may just look that way when bags under my eyes form. Either way, best to drink lots of water!

I plan to take more pictures and share once things settle down, hopefully within the next month. I promise I'll upload better things then!

Better picture...

Nearing 3 months post-op. Not much more to say. Every once in awhile there's some slight tightness in my upper mouth but nothing unpleasant or even much noticeable. I'm starting to forget I have cheek implants. I will say there's still some slight sensitivity if a lot of force is pressed against my cheeks. But best to avoid that anyway! I'm pretty sure chin filler is 100% dissolved. Yet I'm feeling happy with my natural chin right now. Starting grad school in August for my MSW. woohoo!!!!

Just another pic update...

not much has changed. I realized I still have a tiny bit of numbness on the far right of my right eye, near the malar area. It's not something that bothers me in everyday life or I even notice. I think it's just taking longer to heal than the other areas. I am 100% happy with my cheeks now. They filled out my face perfectly. I rarely even think about the fact that they're "not mine". Look and feel completely natural.
Richmond Oral & Maxillofacial Surgeon

I cannot speak highly enough of Dr. Niamtu. I live in southern PA and had to travel 3.5 hours to get here and have no regrets in doing so. I went for my consultation with Dr. Niamtu in December 2015. He was just as impressive and genuine as he seemed in his online presence. I have met approximately 8 or 9 other plastic surgeons in total throughout my cosmetic surgery experiences, and only one has ever come close to his wonderful customer service. He is patient, thorough, and does not rush you, which is almost unheard of in this industry. Dr. Niamtu gave me both his personal cell number and e-mail address after the consultation and was very responsive to my many questions before surgery, as has been his nursing and patient coordinator staff. Dr. Niamtu and his staff were UP FRONT about every single possible complication that can go on, the duration and healing I can expect. Every other plastic surgeon I've seen has only shared information about surgery complications upon my inquiring about it. Additionally, Dr. Niamtu made himself present to me multiple times on the day of surgery where again, many surgeons do not. Dr. Niamtu does a lot of teaching for other doctors and the public (and you can find tons of his publications online!). He also does pro-bono work and has a humongous book in his office filled with hundreds of thank-you cards from patients. He is a person of integrity who loves his job.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
4 out of 5 stars Wait times
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