Thank you for your question.
You submitted two photos, one showing you without the enhancement of an editing program
where you want to see if you can achieve a result using cheek implant.
Well, certainly, I think that your desired outcome is very well-defined with the editing
program that you used and I can certainly share with you how I discuss this type of
question with my patients in my practice.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
And as a surgeon, I have certainly performed a lot of facial implant procedures in my career
and cheek implants as being one of the most common.
So, I would share the evolution of my thinking for patients, like yourself, have a certain
desired outcome and making a decision whether to choose the surgical route versus a non-surgical
route.
So to begin with, where you are showing a desired improvement, it appears to be in an
area in the cheekbone that is really right below the hollows of the under eye area.
And this is an area that we typically refer to as the V deformity.
So it’s closer to the eye as well as below and adjacent to the eye.
So that being said, the area that we’re really looking at is an area that cheek implants
really don’t serve exactly.
Now of course, facial implants can always be customized to get a certain desired result.
But I can tell you that, in my practice of over 20 years that there’s been a great
evolution in options for customizing a patient’s appearance and in a way decide very clearly
what’s optimal: an implant versus an injectable.
There’s been a remarkable evolution of injectable fillers particularly since the introduction
of Restylane in 2005.
So when we have these injectable fillers as an option, what gives those fillers an advantage
versus an implant?
Well, there are a couple of things.: one is, is that someone like yourself who’s relatively
young who is looking to see if there’s a way to do what is done with the imaging program,
I think it’s more achievable with a filler than it is with an implant.
And with a filler like anything in the hyaluronic acid family, it’s actually reversible.
Basically, if someone doesn’t like the result of what’s done with the hyaluronic acid,
they can actually have that material dissolved with an enzyme called hyaluronidase.
So that being said, that provides a little bit of a safety valve in case you don’t
like the outcome.
Another part of injectable fillers, the newer fillers such as Juvederm Ultra Plus and Juvederm
Voluma is the viscosity and thickness of these fillers really makes the augmentation at the
bone level really great.
We do something called structural volumizing in our practice where we actually place the
fillers at the bone level.
Now this is something that most practitioners don’t do.
They typically do it more at the soft tissue level which for a younger person may be somewhat
equivalent.
But in my experience, I feel that when you place a material at the bone level, you really
enhance and create a very nice and natural contour.
And so, that being said, that makes this option of an injectable filler that’s thicker and
that’s long lasting very attractive and the reversibility of it makes it further beneficial.
And last but not the least, the results of our structural volumizing procedures takes
less than 30 minutes and are done in an exam room as opposed to going into an operating
room.
Very often, I’ll tell patients who are interested in a cheek implant to first try the injectable
filler to see if they like the look.
Do they like the outcome or the results?
And if they like that, if I feel that I can duplicate that look with a cheek implant then
that’s the way to go.
Sometimes they often find that the convenience of coming in, getting it done, going to work
the same day or the next day, basically gives them the free time where they would’ve had
to take a little bit more time for a surgical procedure.
So again, there are pros and cons of both options but I would probably advise someone
younger like yourself to first try injectable fillers.
So I hope that was helpful, I wish you the best of luck and thank you for your question.