Esta información y sus vínculos no se debe considerar un consejo médico si no ha habido una consulta en persona con historia clínica y examen físico

Cheek Surgery - Malarplasty

Information in spanish

The cheekbones, malar bones, or zygomatic bones are the bones that support some of the muscles of the face. Malar bones form the elegant prominences of cheeks.  A weak cheek structure or a narrow or flat face, (malar hipoplasia), may give an aged look and a gaunt appearance. Cheek augmentation is an effective facial surgical procedure that helps to correct these conditions.

Cheek augmentation is usually done on an out-patient basis, and may be done in conjunction with other facial procedures, such as nose surgery or eyelid surgery. This operation is the facial surgical procedure that is intended to correct an asymmetry, or to make the cheekbone’s in a person’s face more pronounced. A patient who wants more prominent cheekbones can have a little implant placed to rest on top of their cheekbones. Cheek implants can be made of different material and come in many different sizes and shapes depending on the patients needs. The 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 use the incisions made for an eyelid surgery, external incisions near the eyes. According to the bone structure of the patient, the operation may be vestibular, palpebral, or coronal.

Cheek augmentation can be made of different materials. Fat can be removed from an area of excess of your body and then be injected to fill sunken cheeks. Also, solid silicone and dermal fillers are materials that can be used as cheek implants. Other procedures that can improve the results, such as eyebrow lift, upper and lower eyelid surgery, facial contour (jaw line), and neck skin treatment, are sometimes done in conjunction with this procedure to achieve the maximum improvement.

On the other hand, individuals with very prominent malars, frequently request a reduction malarplasty. This is a facial surgical procedure to improve facial contours by performing an osteotomy through an intraoral incision, resulting in minimal invasiveness, with no external scarring. In a personal consultation with
Dr. Espinosa, he will determine what is reasonable and safe in your specific case.

Most cheek augmentation procedures are done on an out-patient basis. After surgery, you will be taken to a recovery room to be closely watched for 1-2 hours or until your physician considers you ready to go home. You will wake up quickly and comfortably, feeling no pain and experiencing no anxiousness. As hours pass by, it is possible you will feel some temporary discomfort that can be controlled with pain medication. As with all surgeries, swelling will be an issue. As time goes by, the swelling and bruises will dissipate. Remember that it is completely normal for you to feel some tightness or numbness due to swelling. This is part of your healing. Be sure to arrange for someone to drive you home and to stay with you at least the first night following the surgery. Dr. Espinosa will be in permanent contact with you to be certain you are comfortable. Please, do not hesitate to communicate with us if you are concerned about something you consider significant.

Frequently Asked Questions - Cheek Surgery - Malarplasty

Am I a candidate for malarplasty?
If you feel you were not born with good cheekbones, or your face is too flat due to hereditary facial features, it is possible you need a malarplasty. Your surgeon can determine your needs. The surgeon carefully analyzes the areas of your face you want to correct or improve, and through a computer imaging study, he designs a specific treatment for you. Dr. Espinosa usually orders an x-ray study, and some lab testing, to examine your bone structure, as well as your general state of health prior to surgery.

How a malarplasty is performed?
Malarplasty is a facial surgical procedure that improves the facial structure. Implants are inserted through small incisions inside the mouth under the gum and the upper lip, with no external scarring. Because suture (stitches) material is usually of a resorbable nature, suture removal is unnecessary.

When can I go back to work after cheek augmentation?
Most patients are able to return to work quickly. However, this will depend on the individual patient. You should resume gradually your normal activities after one week. Take your time to recovery. Because swelling may still be present, patients who are very concerned about privacy take two weeks to recover. For exercise you should wait a little longer.

May I use dermal filler instead of a silicone implant?

Yes. Taking your own fat, from your abdomen for example, with a kind of liposuction cannula, the fat is prepared and then injected into the patient to restore volume and definition. The preparation process clears the fat of unwanted ingredients that could cause infections of other undesirable side effects.

What should I expect after surgery?

Usually sedation and a local anesthetic are administered in the operating room during a malarplasty. When malarplasty is performed in conjunction with other procedures, it might be necessary to use general anesthesia.
How long will I stay in the operating room?
It usually takes from 1-1 ½ hours. When malarplasty is performed in conjunction with other procedures, it may take a little longer.

Dr. Espinosa´s special instructions:

Instructions before surgery:

  • Avoid taking Aspirin (acetyl salicylic acid) or anti-inflammatory medicines.

  • Stop smoking at least one month before your surgery.

  • Inform your surgeon about drug allergies, medical treatments, and current medications.

  • Always have realistic expectations about the results of surgery.

Instructions after surgery:

  • Before you leave the medical center, make sure you have your surgeon’s prescriptions, medical certification, and date of your first post-operative visit to the office.

  • Stay on a liquid diet until the incisions are healed.

  • Although patients report minimal pain, they are discharged with post-operative analgesia. If you have severe pain, inform Dr. Espinosa immediately.

  • Avoid taking Aspirin (acetyl salicylic acid) or anti-inflammatory medicines.

  • You may be instructed to apply cold compresses over your face for 20 minutes, every 4 hours, for the first two days after surgery.

  • Keep your head elevated during your recovery. Sleep on your back with your head elevated at least for the first 8 days. It is necessary to sleep strictly on your back so as to prevent swelling on one side or any complication. Sleep on two pillows to keep your head elevated or use a wedge-shaped foam pillow. You must sleep face up.

  • You should be able to read or watch television after surgery.

  • Do not wear any facial makeup or eye makeup for the first two weeks.

  • Avoid strenuous activity, including exercise and sex. Do not carry or lift heavy objects for 3 weeks. Light aerobic exercise is allowed just 3 weeks following surgery. Return to normal aerobic exercise after 6 weeks. However, Dr. Espinosa will observe your recovery and will let you know when you can resume your usual physical activities.

  • Lifting heavy things, animals or children may affect the area of surgery. You must avoid any activity that increases the risk of hitting.

  • Excessive exposure to sun in the first 2 months following surgery may result in prolonged facial swelling and injury to the skin. Thereafter, you should always protect your skin with a strong sun-screen. Exposure to sun should be limited or skin discoloration may occur. You must be protected under an umbrella or a hat. Wear sun glasses. Try to keep out of the sun as much as possible.

  • You can resume gradually your normal daily activities in about 8-10 days, as long as you avoid strenuous activity and protect yourself from being hit.

  • Post-operative swelling, discoloration and ecchymosis in the periocular area are very common until approximately 15 days, and should not be considered a complication.

  • Minor asymmetries between two cheek implants may be noticed on close inspection and are generally considered acceptable.

  • Avoid pressure at the site of surgery and do not massage the area. The basic idea is to “fix” the implant in place. You do want to displace the implant from its place.

  • For intra-oral incisions, keep your mouth clean. You may be asked to use an antiseptic mouthwash several times by day, until the incisions are healed.

The information provided here is not a substitute for a consultation. Please, do not hesitate to communicate with us if you are concerned about something you consider significant. Your post-operative appointment is really important. Remember, the success of your surgery depends very much upon post-operative care. It is crucial that you follow your surgeon’s instructions.

Cheek Surgery - Malarplasty