From full lips to high cheek bones, a wide array of alternatives are available to highlight the key features of your face, giving you a more vibrant, attractive look. Well formed cheek bones and a strong chin give definition and balance to your face. Loss of volume in these areas are often seen with the aging process or weight loss but can also be associated with congenital deformities, medications and post traumatic changes.
Areas that require just a small amount of volume are most often treated with one of the injectable fillers- Juvaderm, Perlane, Restylane or Radiesse. These fillers have the advantage of convenience- they are quick, accurate and relatively easy to undergo. They do have some disadvantages, though, as they are somewhat temporary in nature and the associated costs may be a bit high over time if larger volumes are needed.
Two other options are possible- fat transfers and facial bone implants. Chin and cheek implants are the most common but other implants exist for the nose, jaw and lips. These implants are made of several different substances and are available in many shapes and sizes. I prefer silastic implants, an inert substance that is soft allowing them to sit snugly on the underlying bone. One advantage of implants is that they are a “what you see is what you get” type of procedure. That is, there is no resorbing or dissolving of the implant with time providing a lifelong augmentation.
Chin implants for augmentation (mentoplasty) are usually placed via small incisions either in the mouth or under the chin, and the procedures are typically performed with general anesthesia. There may be some bruising and swelling with most resolving within two weeks. Cheek augmentation is also known as malar augmentation and may involve incisions within the upper mouth or along the lower eyelids.
Fat grafting (fat transfers, fat injections) deserves special notice. This is a wonderful technique for augmenting the cheek area and is also used in many other areas from the brows to the lips. Small fragments of fat are grafted (sometimes we use the word transferred) into the area requiring volume. With time, some of the fat will establish itself in the new area providing volume to that area. The expected amount of fat to survive in an area depends on the different anatomical sites.
Fat grafting requires obtaining fat somewhere else on your body. This done with a mini liposuction technique, usually with local anesthesia. The fat is processed and ultimately placed in small syringes and then injected in to the area on the face that requires filling. Technique is extremely important in the amount of “take” of the fat. Fat injections to the face can be done separately or in conjunction with other procedures, most commonly a facelift.