Question 1

What are cheek implants?

Accepted Answer

Cheek implants (aka malar implants) are permanent additions to the underlying facial structure. Typically made of a solid, pliable silicone, cheek implants can be surgically placed into different areas of the cheek to restore volume or lift, changing the contours and appearance of the face.

People choose this type of cheek augmentation for a variety of reasons. Due to genetics, you may have never developed the desired volume in your cheeks, so your cheeks seem too flat. This can make your face appear thin, drawn, and long. For others, hollow cheeks can be one of the signs of aging, as soft tissue is lost and skin loosens.

Cheek implants can restore roundness to your cheeks, the hallmark of a youthful facial shape. They can also create higher cheekbones, giving the face a more sculpted look.

"Implants are manufactured in a large array of thicknesses, sizes, and shapes," says Dr. William Portuese, a facial plastic surgeon in Seattle. While the implants themselves should never be noticed through the skin, the results can range from subtle to striking, depending on your underlying bone structure and the size, shape, and placement of the implants.

RealSelf Tip: If you're considering cheek implants, you're in good company. The number of cheek implant surgeries has increased by 932% between 2000 and 2020 (from 10,427 to 108,189), making it the eighth most popular plastic surgery procedure, according to recent statistics from the American Society of Plastic Surgeons.

Question 2

What are the pros and cons of cheek implants?

Accepted Answer

Pros

Higher, fuller cheeks can give your face a more youthful appearance, better proportion, and a more sculpted appearance.
Cheek implant surgery is a quick outpatient procedure.
Facial implants are usually placed through an incision inside the mouth, so there's no visible scar.
Properly sized and placed cheek implants look natural and imperceptible—even as you age. "Cheek implants are placed directly over the maxillary bone and are located completely under all of the soft tissues in the face, so the face just continues to age naturally," says Dr. Portuese.
Though meant to be permanent, cheek implants can be removed if you don't like the way they look or a complication develops.
The procedure can be combined with other types of cosmetic procedures, including a facelift, rhinoplasty (nose job), brow lift, chin implant, or eyelid surgery, for complete facial rejuvenation.
A cheek implant procedure can actually be less expensive than regular cheek filler treatments, which temporarily increase volume in the midface.

Cons

Cheek implants are usually placed under general anesthesia, which—while very safe, when administered by a qualified anesthesiologist—does come with risks.
Visible bruising and swelling after surgery lasts about two weeks.
Cheek implants can be a challenge to place correctly, and if they're malpositioned, asymmetry can be noticeable enough to require revision surgery. Be sure to consult a provider who's highly experienced in this surgical option.

Question 3

Who's a good candidate for cheek implants?

Accepted Answer

Candidates for cheek implants typically have a naturally narrow or flat face, or have lost their natural cheek contour due to aging

"Good candidates are physically healthy, don't smoke, and have specific goals in mind for the improvement of their cheeks," says Dr. Jed Horowitz, a plastic surgeon in Newport Beach, California.

The amount of change required for a good result varies by a person's anatomy and their aesthetic goals, says Dr. Portuese. "It's important not to place too large of an implant, since it will look very unnatural. Sometimes we will place asymmetrical sized cheek implants, to correct natural facial asymmetry."

Question 4

How much do cheek implants cost?

Accepted Answer

Plastic surgery fees vary considerably based on geographic location, where the surgery is performed, type of anesthesia, and the expertise of your surgeon.

Cheek augmentation surgery is considered a cosmetic procedure, so it’s not covered by medical insurance.

A cheek implant procedure is frequently performed in conjunction with other cosmetic surgeries, such as rhinoplasty, facelift, and chin implant. Combining surgical procedures can potentially save a significant amount of money because you’ll only pay once for the anesthesiologist and the operating room. Your surgeon may also give you a discount when you have multiple plastic surgeries done at the same time.

If you want cheek implants, but aren't sure how you'll afford it, speak to your surgeon about financing options.

See our complete guide to cheek implant costs

Question 5

How does cheek implant surgery work?

Accepted Answer

“In our practice, we place cheek implants under general anesthesia, as an outpatient procedure,” says Dr. Portuese. “The implants themselves are inserted through an intraoral incision [through the inside of the cheek].” Implants can also be placed via a local anesthesia with sedation, so you'll be awake, but feel drowsy, relaxed, and comfortable.

Malar implants are placed on the cheekbones to provide higher projection, whereas submalar implants are secured on the bony area on the underside of the cheek, to make your face look less gaunt. A combination of the two creates full facial volume.

During the procedure, a small incision is made just above the top of the gum line inside the mouth, and a pocket is created to slide the implant directly over the bony surface of the cheekbone, under the skin. Once the implants are in place, small sutures are used to close the surgical sites and promote healing. The stitches will typically dissolve on their own within the first week.

The incision is hidden inside the mouth, so you won't have visible scars.

Once the implant is positioned, it may be secured with a permanent screw. The whole procedure takes about one hour. You'll be groggy from the anesthesia, so have someone you trust there to take you home afterward.

RealSelf Tip: A minority of providers prefers to place cheek implants through an incision in the lower eyelid. This requires an experienced eyelid surgeon, so that no tension is placed on the lower lids to cause eyelid retraction, when the eyelid appears pulled back away from the eyeball. If you're having an eye lift at the same time as cheek implants, your plastic surgeon may use the same incisions for the procedures.

Question 6

How long does recovery take?

Accepted Answer

You'll need up to a week of recovery time, though the recovery itself is relatively easy. Your surgeon can prescribe pain medication to help keep you more comfortable during the first few days of recovery.

Most of the swelling and bruising will subside within two weeks.

Because you’ll have stitches in your mouth, you have to brush very carefully in order to not disrupt the gumline until the stitches dissolve, usually within a week. You will likely be prescribed antibiotics, to help prevent infection.

You’ll also be on a liquid diet for the first 24 hours, and you’ll have to avoid foods with hard or sharp edges for six to eight weeks after surgery.

You may have temporary facial numbness or lack of sensitivity (including on your upper lip), which can last up to three months as nerve endings heal.

It's also not unusual for skin around the implant to feel tight. Your mouth and upper lip may also feel tight and have limited mobility for up to six months afterward. This will soften with time, as the skin stretches to accommodate the implants.

With your doctor’s permission, you should be able to return to work within a week. When the swelling fully subsides (which can take as long as six weeks), you’ll be able to see your full results.

Question 7

How soon will you see results from cheek implant surgery?

Accepted Answer

You should be able to see immediate volume and roundness in your cheeks, though swelling may somewhat obscure your new cheek shape.

As swelling subsides over the next few weeks, your cheeks will appear more naturally contoured.

After about three months, your tissues will have settled and your final face shape will be apparent.

Question 8

Do cheek implants last forever?

Accepted Answer

The results from cheek implants are considered permanent and last forever.

Cheek implant results aren't affected by aging, according to doctors on RealSelf. As long as the implants are the right size and shape, and they're properly placed, they should look natural for the rest of your life, and shouldn't fall, drop, sag, or shift.

"I passed a patient of mine on the street in whom I'd placed cheek implants 25 years ago. They still looked great and the patient was very happy," says Dr. Toby Mayer, a facial plastic surgeon in Beverly Hills, California.

Question 9

Do cheek implants change your smile?

Accepted Answer

Cheek implants are placed below the smile muscles directly over the bone, so they don't affect your smile, says Dr. Portuese.

If placed correctly, cheek implants shouldn't be noticeable at all. "The implants themselves are tapered, so it's very rare to ever see the edge of the implant if they're placed properly," says Dr. Portuese.

Question 10

Are cheek implants safe?

Accepted Answer

Cheek implants have been used since 1956 and have a proven safety record, according to Johns Hopkins Medicine. Though they're typically made out of silicone, they may also be made from Medpor (porous polyethylene), Gortex, or hydroxyapatite (a substance much like tooth enamel and bone), all materials that are all widely used for medical purposes.

When placed by an experienced board-certified surgeon, these devices are considered very safe.

That being said, any surgery carries risks, including hematoma, swelling, bruising, numbness from nerve damage, persistent pain, poor healing, and side effects from anesthesia. The incidence of complications with facial implants isn't high, but certain problems may develop which require implant removal.

A study from 2018 reported that the most common complications of facial implant surgery, including cheek implants, were infection, implant migration, swelling, and extrusion.

It’s also possible for thick scar tissue to form around the implant (capsular contracture).

Implant migration can also be a risk. The scar tissue that forms around the pocket the implants are placed in usually keeps them in position, but while some providers secure the implants to the bone with a tiny screw to ensure they don't migrate, there's no consensus on whether to screw cheek implants to the bone to secure them.

Bone resorption (bone loss) has also been reported below solid facial implants, but doctors on RealSelf who have extensive experience with cheek implants don't believe it's a serious—or even valid—concern. "Bone is living tissue, and it remodels. We have been performing cheek implants for over 25 years and have never seen bone resorption be an issue," says Dr. Portuese.

Your facial plastic surgeon should explain all of these risks in detail.

Question 11

Cheek implants vs. fillers or fat transfer: which is better?

Accepted Answer

Many providers believe that cheek implants are the gold standard of cheek augmentation, since they usually make the most dramatic improvement. But there are other other ways to add projection to the cheek area.

Injectable fillers are placed in the soft tissue under the skin and above the bone to add volume quickly, at less expense than cosmetic surgery. Examples include Restylane Contour, which was recently FDA-approved for the cheek area, and Juvéderm Voluma XC, which is FDA-approved for use in the midface. There's no downtime with fillers, but results are temporary, and "must be repeated every six to nine months to maintain fullness," making them a more expensive option in the long run, says Dr. Portuese. Fillers are a good option if you're not ready for surgery, or as a way to "try out" cheek enhancement, to see if you like the effect on your facial contours.
Facial fat transfer (aka fat grafting) is a minimally invasive surgical procedure, during which your surgeon takes some of your own body fat from your hips, thighs, or stomach via liposuction and injects it into your midface to add or restore volume. Fat grafting avoids potential issues associated with cheek implants, and for many providers it's the prefered filling material. "Fat grafting is one of the best fillers for cheeks, as it's more permanent and has minimal complications," says Dr. Kurtis Martin, a plastic surgeon in Sharonville, Ohio. However, because only a limited amount of fat can be grafted at any given time, and up to 60% of transferred fat cells won't survive, results can be unpredictable.

Both of these options give you immediate results, so ultimately, the procedure that’s best for you will depend on your preferences about cost, recovery time, the number of treatments you're comfortable having, how long you want your results to last, and whether you're comfortable having surgery.

According to Dr. Portuese, cheek fillers have become extremely popular over the past several years. "Patients would much rather have an in-office temporary injectable than a permanent surgical fix."

That said, he notes that in his practice, most cheek implant procedures are performed on patients who have grown tired of doing fillers all the time. "It's much cheaper in the long run to perform cheek implants than it is to go in every six months for fillers."

Question 12

Sources & studies

Accepted Answer

American Society of Plastic Surgeons: 2020 Plastic Surgery Statistics Report.

Johns Hopkins Medicine: Cheek implants.

Rayess, Hani M., et al. "Adverse Events in Facial Implant surgery and Associated Malpractice Litigation." JAMA Facial Plast. Surg. 2018 May-Jun; 20(3): 244–248.

CHEEK IMPLANTS

Karyn Repinski

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	Cheek Implants surgical	Dermal Fillers nonsurgical	Facial Fat Transfer surgical
Worth It Rating	56%	90%	89%
Average Cost	$11857	$1592	$7093
Downtime	1 week of downtime	Minimal or no downtime	1 week of downtime
Anesthesia	General anesthesia	Topical or no anesthesia	Local anesthesia

Karyn Repinski

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