Enhancing your appearance with facial implants
The appearance of your face is determined by three basic components: skin, soft tissues and underlying facial bones. If the structure of your face is disproportionate — the chin is recessed, the jaw undefined or cheeks are ﬂat — it can significantly affect your self image.
Defined facial features, visible contours and natural angles that are proportionate all create structural balance in your face and a more attractive appearance.
If you are bothered by a small chin, weak jaw or lack of facial contour, plastic surgery with facial implants may benefit you. While any area of your face can be augmented with implants, the cheekbones, chin and jaw are the most common sites for facial implants.
Facial implants bring balance and better proportion to the structural appearance of your face. They define your face by increasing projection and creating more distinct features.
Is it right for me?
Plastic surgery with facial implants is best performed on people whose head and skull have reached physical maturity, which generally occurs in late adolescence. This procedure is a good option for you if:
- You are physically healthy
- You do not smoke
- You have a positive outlook and specific goals in mind for improvement of facial contours
Facial implants are specially formed solid, biocompatible materials designed to enhance or augment the physical structure of your face. The precise type and size of implants best suited for you requires an evaluation of your goals, the features you wish to correct and your surgeon’s judgment.
Chin implants can increase the size and projection of a chin that does not project in proportion with the forehead and mid-face. A small or recessed chin can also be described as one that seems to disappear into the neck of an individual of normal weight, rather than appearing as a distinct facial feature.
Jaw implants increase the width of the lower third of your face. Much like the chin, a weak jaw can be thought of as one that is not well-defined and distinct from the neck, or one that slopes rather than angles from the ear to the chin. In some cases, both the chin and jaw can contribute to facial imbalance.
Cheek implants increase the projection of the cheekbones. They add volume to areas which may be recessed or ﬂat.
If symmetry among facial features is part of your goal, facial implants may be recommended to augment more than one facial region. It’s important to remember that all of our faces are asymmetric to some degree and your results may not be completely symmetric. The goal is to create balance and proportion. Your procedure may be performed alone, or as a complement to other facial contouring procedures such as nose or ear surgery.
The success and safety of your facial implant procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.
Be prepared to discuss:
- Why you want the surgery, your expectations and desired outcome
- Medical conditions, drug allergies and medical treatments
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
- Previous surgeries
Your surgeon may also:
- Evaluate your general health status and any pre-existing health conditions or risk factors
- Take photographs for your medical record
- Discuss your options and recommend a course of treatment
- Discuss likely outcomes of facial implant surgery and any risks or potential complications
Prior to surgery, you may be asked to:
- Get lab testing or a medical evaluation
- Take certain medications or adjust your current medications
- Stop smoking well in advance of surgery
- Avoid taking aspirin and certain anti-inflammatory drugs and herbal supplements as they can increase bleeding
Special instructions you receive will cover:
- What to do on the day of surgery
- The use of anesthesia during your procedure
- Post-operative care and follow-up
Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Step 2 – The incision
The chin: For a chin implant, the incision may be inside your mouth, along the crease that joins your lower lip and gums. An incision just beneath the chin is an alternative.
The jaw: These implants are generally placed through the mouth with incisions inside the mouth, further back along the jawline, at the crease where the inside of your cheek and gums meet.
The cheek: The specific area to be augmented in the cheek determines where an implant will be positioned on the cheekbone. Cheek implants are most often placed through incisions in the mouth. When performed with other procedures, alternate incisions may be recommended including placement through an incision inside the lower eyelid or one within the hairline.
Step 3 – Closing the incisions
Your incisions will be closed with absorbable sutures or stitches that will be removed within 1-2 weeks following your surgery.
Step 4 – See the results
While the initial outcome of plastic surgery with facial implants is noticeable almost immediately, it will be obscured by visible swelling. It may take several months for swelling to fully dissipate.
The decision to have facial implant surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo, the alternatives and the most likely risks and potential complications.
Some of the risks include:
- Unfavorable scarring
- Bleeding (hematoma)
- Poor healing of incisions
- Anesthesia risks
- Change in skin sensation
- Damage to deeper structures — such as nerves, blood vessels, muscles, and lungs — can occur and may be temporary or permanent
- Allergies to tape, suture materials and glues, blood products, topical preparations or injected agents
- Excessive scar tissue formation
- Firmness around the implant
- Shifting of implants and pressure on surrounding structures
- Skin contour irregularities
- Skin discoloration and swelling
- Skin sensitivity
- Deep vein thrombosis, cardiac and pulmonary complications
- Blood clots
- Pain, which may persist
- Possibility of revisional surgery
Be sure to ask questions: It’s very important to ask your plastic surgeon questions about your procedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.
Where will my surgery be performed?
Facial implant surgery may be performed in your plastic surgeon’s accredited office-based surgical facility, an ambulatory surgical facility or a hospital. Your plastic surgeon and the assisting staff will fully attend to your comfort and safety.
When your procedure is finished, bandages or dressings may be applied to keep the surgical site clean and to support the position of the implant during initial healing.
You will be given specific instructions that may include: How to care for your face following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, and when to follow-up with your plastic surgeon.
You’ll need help
If your facial implant surgery is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.
When you go home
If you experience shortness of breath, chest pains or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.
Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.
Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.
- Where will I be taken after my surgery is complete?
- What medication will I be given or prescribed after surgery?
- Will I have dressings/bandages after surgery?
- When will they be removed?
- Are stitches removed? When?
- When can I resume normal activity and exercise?
- Will I receive specific dietary instructions?
- When do I return for follow-up care?
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.
The final results of your facial implant surgery will be long-lasting, however the initial healing phase may include localized swelling, discoloration, numbness or discomfort.
In addition, facial movements may be temporarily restricted or impaired. These are common conditions.
Cost is always a consideration in elective surgery. Prices for facial implant procedures can vary widely. A surgeon’s cost for facial implants may vary based on his or her experience, the type of procedure used, as well as geographic location. Many plastic surgeons offer patient financing plans, so be sure to ask.
Cost may include:
- Surgeon’s fee
- Hospital or surgical facility costs
- Anesthesia fees
- Implant cost
- Prescriptions for medication
- Post-surgery garments
- Medical tests
Most health insurance plans will not cover facial implant surgery, related complications or another surgery to revise the appearance of your face. You must carefully review your health insurance policy.
Your satisfaction involves more than a fee
When choosing a plastic surgeon for facial implants, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.
- Biocompatible materials: Synthetic or natural material used in facial implants and designed to function along with living tissue.
- External incisions: Surgical incisions made on the surface of your skin.
- General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
- Intraoral incisions: Surgical incisions made inside the mouth.
- Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
- Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
Use this checklist as a guide during your consultation
- Are you certified by the American Board of Plastic Surgery?
- Were you trained specifically in the field of plastic surgery?
- How many years of plastic surgery training have you had?
- Do you have hospital privileges to perform this procedure? If so, at which hospitals?
- Is the office-based surgical facility accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
- How many procedures of this type have you performed?
- Am I a good candidate for this procedure?
- Where and how will you perform my procedure?
- What shape, size, surface texturing, incision site and placement site are recommended for me?
- How long of a recovery period can I expect, and what kind of help will I need during my recovery?
- What are the risks and complications associated with my procedure?
- How are complications handled?
- What are my options if I am dissatisfied with the cosmetic outcome of my facial implant surgery?
- Do you have before-and-after photos I can look at for each procedure and what results are reasonable for me?