Facial Implants

Facial implants are used to balance facial contours and to augment areas of poorly defined tissue. Chin implants and cheek implants are most frequently employed, but other treatment options are available. The use of implants is an effective solution to enhance facial proportions.

The facial skeleton, as conveyed through the soft tissues, is the deep determinant of the three-dimensional shape of a person’s face. The skeleton will determine whether a face is wide, narrow, long, angulated, round etc. Consequently, irregularities and bone deficiencies are also apparent on the surface of the skin.

Aesthetic balance of the face

Prominent malar bones (high cheekbones) are associated with youthfulness and facial attractiveness in most cultures. Strong malar eminences will add structural support to overlying tissues, reduce the formation of eye-bags and counteract gravitational descent of soft tissues in the cheek and mid-face. Some individuals maintain a youthful appearance despite ageing and this can be often be attributed to their high cheekbones.

The chin is the most important aesthetic landmark of the lower face, which together with the nose determines facial balance in profile. In both men and woman a prominent chin will counteract age related changes in the lower face and neck, prevent the formation of jowls and strengthen the jaw line.

For the purpose of facial contouring, the use of anatomical facial implants represents localised enhancements of the facial skeleton, which are then conveyed through muscles, connective tissue and fat to the surface of the skin. In contrast, fat transfer restores fullness within the soft-tissues. Thus both methods provide improved facial surface contouring.

The main difference is that a higher degree of three-dimensional contouring can be achieved with facial implants and the improvement is static relative to the bones giving sharper definition; whereas fat transfer is a smoother and flexible restoration of soft-tissue fullness. The two methods of facial contouring complement each other and some patients prefer a combination of both.

Chin augmentation

The simplest and most reliable means for assessment of the chin position is in relation to the chin line ‘chin meridian’; a digital photo taken from the side transposes the line on the facial profile to help determine the ideal positioning of the chin, and the point of optimal lower facial balance. If the chin falls behind this line, it generally means that there is microgenia (receding chin) in the horizontal direction, which can be corrected with chin advancement or placement of an implant.

Men generally have a chin that has a two-point light reflection and more of a squared appearance, whereas on women, the chin has a single-point light reflection. Overall, men have a wider lower face than women do, and their chins can be more projected. The type of chin implant selected will depend on the magnitude of the deficiency. Implants are tailored to the individual and may be small, moderate or large in scale. There are also anatomical implants that extend the width of the chin, further strengthening the jaw line.

Cheek augmentation

The aesthetic function of cheek implants is to produce a smooth, natural contour that in turn provides mid-facial fullness and reduces the nasolabial fold. In addition, cheek augmentation may enhance or restore facial proportions by adjusting the point of maximal projection of the cheekbones (zygomatic arch). In narrow faces, cheek implants can be used to make the face wider, by placing the implants further apart on the outer part of the zygomatic arch. On the contrary, if the distance between the projection points is too long, the face looks wide and flat. By shortening the distance between implants the face can be made to appear more narrow and angular.

The three variables of a cheek augmentation are: Implant shape/projection, implant volume and implant position; which offers opportunities for complete individualisation. The choice of implant and procedure is best reached in consultation so that individual circumstances may be taken into account.

Surgical techniques

Chin and cheek implants can be positioned through either an intra-oral (through the mouth) or trans-cutanous incision (through the skin). The implants are positioned within a small cavity on top of the bone (periosteal positioning), and within 2-3 weeks they will have integrated into a stable position in which they will provide enhanced contours and can't be distinguished from the adjacent facial bones.

Implant size, material and shape are chosen according to each patient's facial form and desired appearance. Dr Sorensen uses implants made of silicone, porous polyethylene (Medpor) or PEEK (Peek-Optima). All three types of implant integrate well, are long-lasting (permanent) and can be removed should this be required.