- If you have low cheek bones to begin with, you’ll look much older than you are a lot faster as the fat begins to atrophy in the midface and flatten out
- Many ways women try to counteract either having no fat or small cheek bones is by putting something there
- Sometimes a surgeon may reinforce it with some sutures that go outside of the skin
- If someone has poor lymphatic drainage, they may naturally have a tendency to form little pockets of edema (bags filled with tissue fluid)
As a woman ages, there are many noticeable changes that occur to her face. Oftentimes, volume is lost and the face begins to look thinner, and the area around the cheeks and below the lower eyelids starts to look flat and lifeless. To reverse this sign of aging, women may consider adding back the volume and life to their cheeks.
Dr. Cory Torgerson, a facial cosmetic surgeon in Toronto, considers cheek volume an important measure of beauty. Although cheek augmentation is often performed on women around their 50s and 60s who find they’re losing the appearance in their cheeks, younger patients may also seek improvement in their cheekbones because of poor structure in that area to begin with. According to Dr. Torgerson, if a woman has high cheekbones structurally, then she ages much better than a woman who doesn’t.
“If you have low cheek bones to begin with, you’ll look much older than you are a lot faster as the fat begins to atrophy in the midface and flatten out,” said Dr. Torgerson. “Many ways women try to counteract either having no fat or small cheek bones is by putting something there.”
There are two available methods for enhancing the cheeks: either an implant can be inserted into each cheek or you can choose to get fillers in that area. Both procedures create higher cheekbones by adding volume and bringing out the youthfulness and beauty in a woman, explained Dr. Torgerson.
If performed correctly by the surgeon, an implant is permanent. Currently the most popular implants, according to Dr. Torgerson, are ones made from solid silicone or Gore-Tex®. Both types of implants can be inserted into the cheek area safely without the body rejecting them. Implants come in a variety of sizes that can be shaped by the doctor based on what the patient requires. Dr. Torgerson recommends implants that are not too big, but instead aim for a size that is slightly smaller than requested to avoid the cheeks looking unnatural.
The surgery is performed under general anaesthesia and take between one to one-and-a-half hours. A two- to three-centimetre incision is made inside the mouth under the upper lip for each cheek. The implant is then fitted into the pocket.
“It stays in place because it’s a snuggle little pocket. Sometimes a surgeon may reinforce it with some sutures that go outside of the skin,” Dr. Torgerson explained. “It sits there and your body forms a capsule around it, and it’s there for eternity.”
Dr. Torgerson suggested two weeks of downtime following the surgery. During this time, there will be some swelling and bruising, along with some tenderness and pain lasting from a week to 10 days.
There are a few risks a patient should consider before undergoing the surgery. Dr. Torgerson mentioned there is a two to three per cent chance of infection after inserting implants, which would then require removal. They may also need to be taken out if the implants shift or move anytime following surgery. There is also a risk of damaging the infraorbital nerve, which is located below both lower eyelids, especially if the surgeon is inexperienced. According to Dr. Torgerson, since it is a sensory nerve, damaging it could cause permanent numbness in the middle portion of the face. While implants are permanent, Dr. Torgerson warns that there may be a potential need for revision, especially if the implants are too big.
“It’s like breast implants. Most people don’t think about what will happen in five to ten years,” said Dr. Torgerson. “As you age, the tissue in your midface shifts and changes. If an oversize implant has been inserted, they can often become quite noticeable with time as the surrounding tissue (bone, fat, soft tissue and skin) changes.”
In order to avoid surgery and potential complications that come along with it, women may seek the alternative – injectable fillers. Dr. Torgerson said this alternative is more popular than cheek implants. The most popular fillers are ones that contain hyaluronic acid, such as Juvéderm®, Teosyal ® and Perlane, which can provide the cheekbones additional height and projection. While fillers are not permanent, they can last approximately a year according to Dr. Torgerson, after which time touch-ups will be required.
Unlike implants, fillers can blend more accurately into the lower eyelids and give better contouring, allowing the cheeks to look more natural even as you age. Dr. Torgerson added that fillers are also reversible because of available enzymes that can be used to break the fillers down.
With fillers, downtime and risks are quite minimal in comparison to implants. A woman can resume regular activity right away, and infection does not occur unless the needle that is used is not clean. Dr. Torgerson explained that the biggest risk that could occur is having too much filler injected.
“If someone has poor lymphatic drainage, they may naturally have a tendency to form little pockets of edema (bags filled with tissue fluid). If you put too much filler in that area, you could make this problem worse,” said Dr. Torgerson.
Dr. Torgerson said now more than ever before doctors are realizing the importance of a natural look.
“Whether we’re using permanent cheek implants or injectable fillers, because doctors are understanding natural is best, we have a lot of tools right now to be able to contour that cheek projection so that it’s all blended.”
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