Cheek augmentation is a

cosmetic surgical procedure Plastic surgery is a surgical specialty involving the restoration, reconstruction or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Reconstructive surgery includes craniofa ...

that is intended to emphasize the cheeks on a person's face. To augment the cheeks, a plastic surgeon may place a solid implant over the

cheekbone In the human skull, the zygomatic bone (from grc, ζῠγόν, zugón, yoke), also called cheekbone or malar bone, is a paired irregular bone which articulates with the maxilla, the temporal bone, the sphenoid bone and the frontal bone. It ...

. Injections with the patients' own fat or a soft tissue filler, like Restylane, are also popular. Rarely, various cuts to the zygomatic bone (cheekbone) may be performed. Cheek augmentation is commonly combined with other procedures, such as a face lift or chin augmentation.

Implants

Materials

Cheek implants can be made of a variety of materials. The most common material is solid silicone. In addition, two popular options are high-density porous

polyethylene Polyethylene or polythene (abbreviated PE; IUPAC name polyethene or poly(methylene)) is the most commonly produced plastic. It is a polymer, primarily used for packaging (plastic bags, plastic films, geomembranes and containers including ...

, marketed as '' Medpor'', and ePTFE (expanded

polytetrafluoroethylene Polytetrafluoroethylene (PTFE) is a synthetic fluoropolymer of tetrafluoroethylene that has numerous applications. It is one of the best-known and widely applied PFAS. The commonly known brand name of PTFE-based composition is Teflon by Che ...

), better known as '' Gore-Tex''. Both Medpor and ePTFE are

inert Inert may refer to: * Chemically inert, not chemically reactive ** Inert gas ** Noble gas, historically called inert gas * Inert knowledge, information which one can express but not use * Inert waste, waste which is neither chemically nor biol ...

substances, providing better integration with the underlying tissue and bone than solid silicone. However, in the case of Medpor, the implants' integration and ingrowth with the underlying tissue causes difficulty removing the implant if revisions are needed.Augmentation options
''All About Cheek Augmentation: A Patient Education and Support Network.'' Last accessed 6 July 2009.

Shapes

There are three general shapes to cheek implants: ''malar'', ''submalar'', or ''combined''. Malar implants, the most common shape, are placed directly on the cheekbones. The result is more projection to the cheekbones, providing a "higher" contour to the side of the face. In contrast, submalar implants are not placed on the cheekbones. They are intended to augment the midface, especially if the person has a gaunt or "sunken" appearance to this area. Combined implants or ''malar/submalar combination'', are an extended implant intended to augment both the midface and the cheekbones.Malar and Submalar Implants: Overview
'eMedicine.com from WebMed''. Medscape. Last accessed 7 July 2009.

Incisions

A surgeon will usually make an incision in the upper mouth near the top of the gum line and slide the implants into place. Another method is to make an external incision near the eye, but most patients do not choose this method since it can create a visible scar. However, the intraoral (inside the mouth) approach carries a higher risk of infection since the mouth contains more

bacteria Bacteria (; singular: bacterium) are ubiquitous, mostly free-living organisms often consisting of one biological cell. They constitute a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria were am ...

. Cheek implant surgery is usually performed under sedation or general anesthesia and take about one to two hours. Recovery from this surgery usually takes about ten days.

Risks

As with any surgery there is a risk of

infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable d ...

, postoperative bleeding, formation of a blood clot, and severe swelling. Asymmetry is a risk with all forms of cheek augmentation. This can occur due to uneven resorption, implant displacement, or shifting. This shift can happen due to swelling, trauma or scarring. Although a temporary loss of sensation is common, an extended loss of sensation can occur with any surgery, especially cosmetic plastic surgery.

Fillers or injections

Injections to the cheekbones to provide a less invasive and less expensive approach to cheek augmentation. A hyaluronic acid, such as Restylane or Juvederm, can be injected to the cheek area.

Autologous Autotransplantation is the organ transplantation, transplantation of Organ (anatomy), organs, Biological tissue, tissues, or even particular proteins from one part of the body to another in the same person (''wikt:auto-, auto-'' meaning "self" ...

fat is considered a "more permanent" option, but all are eventually completely resorbed.

Zygomatic osteotomy

A zygomatic "sandwich" osteotomy is far less common. The procedure is often indicated during reconstructive surgery for

birth defect A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities c ...

s or traumatic

injury An injury is any physiological damage to living tissue caused by immediate physical stress. An injury can occur intentionally or unintentionally and may be caused by blunt trauma, penetrating trauma, burning, toxic exposure, asphyxiation, or ...

. During this procedure, the zygoma, or cheekbone, is separated by bone cuts near the orbital rim and

maxilla The maxilla (plural: ''maxillae'' ) in vertebrates is the upper fixed (not fixed in Neopterygii) bone of the jaw formed from the fusion of two maxillary bones. In humans, the upper jaw includes the hard palate in the front of the mouth. The ...

. The bone is then moved outward and a solid material, such as hydroxylapatite, is wedged in place to hold the new position of the zygoma.Milrolo, Michael et al. ''Peterson's Principles of Oral and Maxillofacial Surgery.'' 1200-1201
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References

{{DEFAULTSORT:Cheek Augmentation Oral and maxillofacial surgery