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Malar Augmentation

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Malar augmentation or cheek augmentation provides volume and contour to the cheek that lacks definition. Strong and prominent check bones are often part of a beautiful and well-balanced face. They help highlight the midface, promote a youthful appearance and aesthetically appealing. Flat cheek areas are usually resulting from an underlying deficient bone structure. It is vital to appreciate the differences between female and male cheekbone structures and what makes them look aesthetically better. Males are usually having a higher cheekbone, whereas the female has a lower and more anterior cheek fullness according to the definition of aesthetic beauty.

The main objective in malar augmentation is to create an ideal facial profile and restore facial harmony that suits individual needs and ethnicity. Depending upon the requirements, malar augmentation can be done either as a single procedure or in combination with several surgical cosmetic procedures such as facelift or chin augmentation. There are various types and shapes of cheek implant that can be used to augment the deficient cheek areas. These implants can be inserted via an incision made intraoral or through the lower eyelid. Other methods of cheek augmentation include autologous fat grafting or filler injection.

Indications

  • An individual who has a positive outlook, realistic expectations and specific goals in mind for the improvement of facial appearance
  • Individual with weak cheek structure, a narrow or flat face
  • Individual who has lost cheek volume or contour due to the effects of disease or ageing

Preoperative preparation and assessment

Communication is vital to achieving the patient’s goals. During the initial consultation, patients will have the opportunity to discuss their goals and desired results with the plastic surgeon. The plastic surgeon will work closely with the patients to reach an agreement about the expectations from the surgical procedures involved and their long term benefits. Every patient is different. Therefore, a specific surgical technique and treatment regimen are planned to suit an individual’s need.

The preoperative assessment for cheek augmentation may involve:

  • Discussion about patients’ expectations and desired outcome
  • Medical conditions, drug allergies and previous medical or surgical treatment
  • Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
  • Blood investigations or a medical evaluation
  • Avoid certain medications or adjust your current medications
  • Stop smoking or alcohol well in advance of surgery, (2-3 weeks before the surgery)
  • Avoid taking aspirin and certain anti-inflammatory drugs and herbal supplements as they can increase bleeding
  • Examination of the face and its soft tissues
  • Radiological assessment (facial X-rays or CT scans)
  • Preoperative evaluation for types of anaesthesia
  • Photography for preoperative and postoperative evaluation

The risks and safety information on cheek augmentation

It is essential for patients to understand that every surgical procedure has its complications and downtime. However, if a patient is appropriately assessed before the surgery and postoperative care is given adequately, these risks can be eliminated or reduced. The risks involved in cheek augmentation may vary depending upon the nature of the surgical procedure. In general, some of the risks involved are:

  • Bleeding
  • Blood clot
  • Infection
  • Bruises and swelling
  • Poor wound healing
  • Persistent pain
  • Scarring
  • Injury to the surrounding nerves, blood vessels, muscles or bones
  • Changes in the skin sensation
  • Skin or bony contour irregularity
  • Problems associated with implants
  • Asymmetry
  • Anaesthesia risks
  • Possibility of revision surgery

Postoperative expectations

During the initial healing phase, the patient may experience pain, numbness, bruises and swelling around the cheeks. Occasionally, the patient may experience tightness during mouth opening. These symptoms are transient; usually, last about 3-4 weeks. Intraoral sutures do not necessary to be removed, but if there are any sutures on the lower eyelid, they are generally removed approximately 7-10 days after the surgery. Oral antibiotics and analgesics will be prescribed to reduce the risk of infection and postoperative pain respectively.

Postoperative care

  • Follow the postoperative instructions given carefully
  • Head elevation especially when sleeping for 1-2 weeks
  • Take the prescribed medications as instructed
  • Regular application of facial ointments and cold compression around operated areas
  • Regular mouth wash or rinse after every meal if there are any intraoral wounds
  • Avoid strenuous physical activities for 3-4 weeks

How much will a cheek augmentation cost?

Cost is always a consideration in elective surgery. The cost of cheek augmentation can vary widely. Cost may include:

  • Surgeon’s fee
  • Hospital or surgical facility costs
  • Medical tests (blood and radiological investigations)
  • Anaesthesia fees
  • Implant cost
  • Prescriptions for medication
  • Post-surgery garment

Cheek augmentation is a cosmetic surgical procedure. Therefore, most of the health insurance companies do not cover cosmetic surgeries or their complications.