Facial Implants

There are a variety of shapes and sizes of various permanent facial implants.  The most commonly used are chin implants, pre-jowl implants and cheek implants.  Facial implants are made from silicone; it is a solid silicone unlike the gel used for breast implants.  There are other materials used but silicone is most common and, our preference.

Chin Implant / Pre-Jowl Implant

A chin implant is positioned directly over the bone of the chin.  It is appropriate for patients with inadequate chin projection which, with age, contributes to poor contour of the neck on side view.  The pre-jowl implant is shaped like a flattened dumbbell.  There is no central projection but it fills in the area just in front of the jowls.

Everyone looses volume (fat and bone) in the pre-jowl area with age.  Patients with a heart shaped face show that loss even more, such that they can appear “jowly” even after a facelift (or before they need one) because the pre-jowl hollow is still inadequate.  A pre-jowl implant can dramatically improve that look permanently.  We often use fat injection as well, to improve the soft tissue loss.  (See Filler, See Fat Injection)

The technique we prefer is insertion through a small incision below the chin.  The scar heals very well and minimizes tooth root related complications and malposition.  The dissection is carried down to the bone and tissues are dissected in the subperiosteal plane to match the size of the implant.  Careful closure in multiple layers is then performed.

Cheek Implants

Cheek implants are placed to provide volume to flat cheeks, anatomically, this is considered the mid-face.  Typically, incisions are made through the upper gums, subperiosteal plane dissected and implants inserted.  Some surgeons prefer access through a lower eyelid incision.  Cheek implants are a great option for patients who truly have inadequate projection of the cheek bone, which is not generally related to aging.

COMMENTARY ON FACIAL IMPLANTS (Dr. Anson)

In my opinion, cheek implants were overused in the past.  It is important to separate which components of the facial tissues are lacking.  However, if it is the soft tissue which is lacking, then volume enhancement via fillers or fat is more appropriate.  The other problem with cheek implant can become more visible.  Volume enhancement over and around the implant is then required.

Another consideration is the position of the soft tissues of the cheek.  There are some patients who have adequate volume, but the cheek has drooped (visualize the cheek sliding off the underlying bone).  In that case, a mid-facelift is in order.  (See Mid-Facelift).