Facial beauty is determined by a combination of facial features, proportions, balance and harmony. Facial implants may be used to improve facial features in many age groups. They not only aesthetically improve bone structure, but can also be used to help reverse the signs of aging. Facial implants are quick and minimally invasive surgical procedures with dramatic results. They can be utilized to achieve facial balance in younger age group and to correct signs of aging.
The following are the most common questions regarding facial implants:
What are the facial implants made of and is my body going to reject them?
The concern of most people is whether an implant material is safe. Most facial implants are composed of solid silicone elastomer or rubber. Solid silicone elastomer is the most common biomaterial used for implantation and has been used safely for over 40 years in almost every field of medicine and surgery. It is used in cardiology as the covering for pacemakers, eye and ear surgery, and orthopedic surgery and many other indications. Silicone facial implants are NOT the same material that were used in gel-filled breast implants. To date, it has the best track record of any biomaterial used for implantation and is the only biocompatible material that has truly stood the test of time. The preformed silicone elastomer implants maintain both the shape and flexibility and thus feel perfectly natural over the facial structure.
What areas of the face can be augmented with Silicone implants?
One of the more dramatic improvements in facial appearance can be achieved by cheek augmentation. Well contoured cheekbones are a sign of beauty. This perception of the high cheekbone is actually only part bone while the other component is also comprised of the soft tissue covering over the bone structure. It is both of these factors that contribute to the desired effect. The older cheek implants which often created an artificial appearance have been eliminated as a result of the new, more anatomically-designed cheek implants. These implants take into account the entire area that we perceive as “cheekbones” and compensate for both the bone and soft tissue components that comprise the aesthetically desirable “high cheekbone effect”.
Submalar or Midfacial Implants
There is evidence that as we age our bone remodels and loses its convexity and becomes more flat or hollow. In addition, the aging process and gravity causes drooping of the soft tissues and fat compartments that normally provide a pleasing, smooth contour over the cheeks. The combined effects cause a drooping or sagging of the skin. This causes the development of folds and wrinkles around the mouth and areas that become flattened, depressed or hollow alongside the folds. Restructuring of the midface by midfacial or submalar augmentation can effectively correct these problems.
A submalar implant acts to reposition relaxed or sagging skin upward and outward to fill the midfacial hollows and depressions and soften the folds and wrinkles. In submalar augmentation we are not changing bone structure, but merely using the implant to provide a scaffolding to hold up the collapsed midfacial soft tissues. For people in their mid-thirties, early loss of a youthful appearance is often due to premature loss of the facial fat which causes a flattened or hollowed appearance to occur over the midface or it may be a congenital mid facial hollowness. In this situation we have found facial contouring procedures such as submalar or midfacial augmentation to be the ideal to restore a youthful appearance back to the face. For those in their mid-forties or beyond, the aging process may mean that the restoration of skeletal and soft tissue dimensions in conjunction with facelift surgery is the ideal aesthetic solution. In some instances, draping of the skin and underlying muscles during facelift surgery is difficult. The folds around the mouth are thus unable to be smoothed out without pulling the skin too tight and results in rapid recurrence of these redundant nasolabial or midfacial folds. The submalar implant may provide the necessary foundation to enable the face lift to further reduce these folds by redistributing the skin more smoothly over a larger, convex structure and thus add a more youthful dimension back to the face.
One of the most common facial implant procedures performed are chin implants. Creating subtle but correct proportion, size, and projection to a small, under-projected chin may add immeasurably to one’s appearance. A small chin can make a person’s nose appear more prominent than it really is, whereas a chin that is more in harmony with other facial features can draw attention away from the nose and give the entire profile a more pleasing balance. Building up a small chin can also dramatically improve the configuration of the jaw-neck line to effectively reduce the “double chin” when performed in conjunction with facelift.
Chin augmentation (chin implant surgery) is the classical operation that changes a person’s profile by bringing out the chin or front portion of the jaw bone. In cases where the teeth do not fit together well or there is a severe underbite or overbite, orthognathic (corrective jaw surgery) would be the recommended treatment.
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Mandibular Angle Implants
Mandibular angle or angle of the jaw can be deficient or lack definition which makes a face look narrow and disharmonious. A stronger jaw line may bring out facial harmony and balance to a person’s face. Indications for mandibular (Jaw) angle augmentation may include people with congenitally small jaw and persons requesting to have more structure and definition in the lower part of the face. This procedure is performed entirely through the mouth with no visible scars on the face.
How is facial implant procedures performed at our center?
Most facial implant or augmentation surgeries are performed as an outpatient procedure under strictly sterile conditions. Let us discuss how each facial implant procedure is performed at our center and what you should expect during and after the procedure. Midfacial (cheek or submalar augmentation) is relatively simple, taking approximately 45-60 minutes and can be performed alone, or in combination with forehead, eyelid, face lift, nose or chin surgery. The procedure is usually performed under local anesthesia (nerve blocks), but may be performed under IV sedation (twilight anesthesia) if preferred. Normally antibiotics are given before, during and after surgery to decrease the risk of infection. Most midfacial implant procedures are performed through the mouth. The incision is made high above the gum line and a pocket is created over the bone. Since the implants come in numerous shapes and sizes, the choice depends on your particular case and desired effect to create the most ideal shape and natural looking result. Different portions of the implant can be carved to further customize the implant to each individual’s unique structure. The appropriately-sized implants are then inserted and properly positioned within the pocket and stabilized to prevent it from moving out of place. Supportive tissue forms around the implant after a few weeks, and once healed it feels like your normal underlying bone structure. Chin implant placement is a relatively minor procedure, performed as an outpatient and takes between 30 minutes. It can be performed alone, or in combination with facelift, nose, eyelid, or cheek implant surgery. It is usually performed under local anesthesia but can be performed under IV sedation (twilight anesthesia) if preferred. Normally antibiotics are given before, during and after surgery to decrease the risk of infection. Different size and shape chin implants may be tried on preoperative exam to find the most appropriate one that will create the most ideal shape and natural looking result for each individual patient. The procedure is performed by making a small incision either in the crease line under the chin or inside the mouth where the lower lip joins the teeth. Placing the incision in the submental crease, below the chin makes the scar (via the external route) virtually inconspicuous. A small pocket is created directly over the bone to approximate the size of the implant. The implant is then inserted into the pocket and over the jaw bone and secured.
What to expect after facial implant procedures?
After facial implant surgery, swelling some bruising can be expected. Although the main swelling is diminished within two weeks, the fine definition and new facial contours gradually emerge after four to six weeks and sometimes longer. If the small incisions are made inside the mouth we recommend a soft diet for few days and don’t forget the importance of good oral hygiene. You will be given specific instructions on how to achieve a good oral hygiene after an intraoral procedure. Pain is minimal with facial implant procedures, however you will be given pain medication and antibiotics to prevent pain and possible infection.