The cheek along with the chin and the lower jaw form the mid to lower facial structures and the shape and size of all the three contribute in making what a face looks like. In the present age of video communications over the internet such as Skype, Face Book and others, people like their faces and other parts of the upper body visible on the screen to appear as attractive as possible. As a result a spurt in cheek and chin augmentation procedures have been observed in America in recent times.

According to the statistics of American Society of Plastic Surgeons (ASPS) the number of cheek and chin cosmetic procedures in 2011 went up by 47% and 71% respectively over the 2010 figures. The total number of procedures done, though, were not large and for cheek augmentation it was 12,000 in 2011. Many women prefer to have high cheek bones. Men and women having sunken or hollow cheeks often prefer to have plumped up middle cheeks. As one ages, the loss of fat in the cheek can results in a sunken look to the skin in this area, called the teartrough deformity. This age related problem can be reversed easily. The filled up cheeks make people look more youthful and energetic while sunken or hollow cheeks give them tired or aged looks.

There are essentially two ways to fill cheeks: 1) Minimally invasive techniques, 2) Surgical check implant placements.

Minimally invasive options

Minimally invasive procedures involve injecting dermal filler like Restylane or Juvederm into the cheeks. Injecting the patient’s own treated body-fat harvested by liposuction is also a way for enhancing the cheeks. The injected body fat may last longer than the other fillers but all of them get fully resorbed ultimately. These can fill the teartrough deformities, enhance and uplift the cheeks, lift and smooth the nasolabial folds, and provide a more youthful look to the face. The results last around a year, while the surgical options, such as the use of silicone or other material implants, however, are long lasting.

Many people prefer to do these minimally invasive procedures first to see if they want these enhancements, plus they do not have to undergoe a surgical procedures which may carry potential complications as noted below. Injecting fillers into these areas can cost from $600 to $3000, depending on how much fill is needed. Juvederm lasts around a year and needs to replaced, but the effects are similar to the silicone implants while no surgery is necessary and the results are  surprisingly wonderful.

Cheek implants options

The cheek augmentations are generally done by placing implants surgically. The material of the implants is mostly silicone, but there are options of other materials as well, like high density porous polyethylene (HDPPE) or other petroleum products. The implants made of petroleum products like HDPPE integrate with the underlying cheek tissues better than silicone implants. This is good in a way but these are also more difficult to remove when revision or repeat surgeries are required.

There are three types of implants depending on the area or shape to be filled: 1) Malar implants which are placed on the cheek bones to make them prominent by higher projection on the face; 2) Submalar implants which are placed on the mid-faces or cheeks to fill out the sunken or hollow areas; 3) Combined Malar Submalar implants which make the cheek bones look prominent as well as fill out the sunken mid-face portions.

The surgeon in consultation with the patient decides on the type of implant to be used depending on the kind of cheek enhancement needed. The cheek augmentations are often done along with chin, lower jaw enhancements and face lift to provide an overall facial improvement.

Surgical procedure: The incisions for emplacement of the implants are usually done inside the mouth at the junction of the upper lip and top edge of the upper gum. Sometimes if the patient allows, the incisions may be done just below the lower eyelash lines. In this case, the incision lines may remain visible for some time and patients seldom like that. On the other hand, incisions made inside the mouth cause more infections due to presence of many bacteria inside the mouth. The procedure may be done under local anaesthesia with I V sedative or under general anesthesia. It may be done on outpatient basis. It takes about one to two hours to be performed. The cost of the surgery may be between $2000 to $3000 plus the hospital and anesthesia charges.

Recovery: The patient may go back home on the same day after the surgery. There may be some pain and discomfort for a few days. The patient may rejoin work after about ten days.

Risks: In surgical cheek augmentation, there are risks which are common in many surgeries like reaction to anesthesia, post operative bleeding, blood clot formation, infection, pain and swelling. Asymmetry may occur due to relative difference in resorption of the implants in the two cheeks, shifting of the implants due to swelling or some kind of trauma. There may be short term or longer term loss of sensation in the operated area similar to other plastic surgeries.