CHEEK AUGMENTATION

High cheekbones have always been a sign of beauty.  For long periods of time, triangular faces with elevated cheeks have been preferred over rounder faces.  In older faces, we tend to lose volume in the cheek area, which is followed by drooping and sagging of the skin tissues.  Also, several illnesses are characterized by hollowing of the face.  Cheek implant surgery can be used to augment and give volume to older patients and patients with certain illnesses; while in younger patients, cheek implant surgery can give a patient the more desired sculpted triangular face.

For men, cheek implants can give a more masculine, assertive appearance; while in women, cheek implants can change a long oval shaped face into a more attractive heart shaped face.

The beauty of cheek implants is the abundance of sizes and shapes now available in implants.  During your consultation, Dr. Blackledge will generate many different computer images of your face with different size implants, and then will help you in deciding which size and shape is most proportioned on your face.

During your consultation, you will actually get to look and feel at an actual cheek implant.  They are made of a silastic material that is similar to materials used in heart surgery.  This material is biocompatible which means it is capable of remaining in our body without being rejected by our body.  With time, the cheek implant is almost impossible to feel against our actual cheek bones.

Before Surgery

We will schedule an appointment for you approximately 10 days prior to surgery.  At your preoperative appointment, our patient coordinator and nurse will review all the instructions for you both prior to surgery and after surgery.  You will receive prescriptions for your necessary medicines at this time, and we will review any of your current medicines that you are taking.  This is also an excellent opportunity to ask our Dr. Blackledge any questions you may have thought about since the consultation.  At the conclusion of your preoperative visit, we want you to feel totally comfortable with your upcoming experience.   Remember, we are here to answer your questions and make the pre-op and recovery process as easy as possible for you.  For many of our long-distance patients, the preoperative appointment may be done over the telephone, via e-mail or even on the morning before surgery if possible.

The Morning of…

Upon your arrival, you will be greeted by one of our nurses, and allowed to change into a more comfortable gown.  Wear something that is comfortable and slides easily over your head or zips/buttons up the front.  You will then be seen by Dr. Blackledge and will discuss any “last minute” questions.  We will also draw on you while you are awake and sitting up – as everything tends to change once you lie down.  Once you feel comfortable and all questions are answered, we will give you a cup of pills that should start to drift you off into a relaxed state.

Cheek implants are placed through a small incision in your mouth and then anchored to the cheek bones by small sutures.  These sutures dissolve in approximately a week.

Even though the recovery period technically starts immediately after surgery, there are several things that you can do before your surgery day to make the recovery period smoother.  During your consultation, we will talk to you about the importance of being physically and mentally prepared for surgery to ensure that we get the best results possible.   Now back to the recovery period.  Immediately after surgery, ice packs are placed on your cheeks to minimize bruising and swelling.   These are worn as often as possible for the first twenty-four hours.   Most patients go home the day of surgery if cheek surgery is the only procedure performed.  The first day after surgery is strictly a “bed rest” day.  Most patients feel better than expected, so the temptation is to “over do” it on this first day.  However, patients have less bruising and swelling if they rest with their head elevated on the first day.  Swelling is typically mild to moderate reaching its maximum on the third postoperative day, and then it starts to decline.  Typically with camouflage makeup and sunglasses, there is little “down-time” involved and you may resume normal activities after a few days.  Pain is rarely significant after cheek surgery.  However, it is not uncommon to feel fatigued for a couple of days after surgery.

Each day during your recovery period, you will probably have a new and different question. You will be given specific instructions regarding  your postoperative care of the cheek areas.  These instructions are meant to help make your recovery period easier and also to ensure that the results of your surgery are as pleasing as possible.

 Bruising

 Bruising is expected after any kind of surgery.  The amount that you bruise is extremely individualized – some people will bruise more than others.  However, with every patient,  we can expect a reduction in the amount that you bruise by taking Bromelain during the preoperative and postoperative period.  We encourage you to drink at least 8 glasses of water each day during your recovery period to flush the bruising out of your system.  Our experience with cheek surgery is that the combination of Bromelain and water intake will reduce the amount of bruising that you normally would have had.
During the recovery period, you will notice that your bruising changes colors.  All bruises initially appear red and change to a purplish hue.  By day five, the majority of your bruises will have changed to a green and then yellow color.  Once you have reached the yellow stage, you are almost “bruise free.”

 Swelling

Just like bruising, expect swelling.  The day after surgery, swelling will actually increase over the day.  Typically, swelling begins to decrease on the third day after surgery.  We often get the question, “what can I do to reduce swelling?”  You will be given ice compresses to place over your cheeks for the first two to three days to reduce swelling.

 Sleeping

It is best to sleep in an upright position with your head at least above the level of your heart for the first week after surgery.  This helps to reduced swelling and also bruising.   The best beds are usually either a recliner or an incline pillow.  Both of these keep the head and shoulders in a natural position.  If you try to sleep with your head elevated with pillows, you wind  up sleeping in an unnatural position and develop muscle spasms in your shoulders.

 Exercise

You may begin light walking on the fourth day after surgery.  In fact, we usually encourage this because it helps to improve your circulation, which in turn gets rid of bruising and swelling quicker.  You can gradually increase the intensity of your walking over the next few days as your body tolerates it.  Your body will tell you how much exercise is enough.  We usually recommend that you refrain from any competitive sports such as tennis or golf for at least two weeks.

Pain

A popular question is “how much pain will I have after cheek implants?”  Most patients will tell you that they had little to no pain after surgery.  The common response is that everything felt “tight.”  This is usually due to swelling and the tight sensation begins to subside after about 2 – 3 weeks.  Patients are given prescriptions prior to surgery for pain medicine and are encouraged to take theme as directed for discomfort.  However, most patients switch to Tylenol soon after surgery.

Eating

The day of surgery, you will want to just have soft foods and liquids as the inside of your mouth may be tender.  Also, with patients who have an incision inside their mouth, we will want you to stay away from foods that may get caught up in the incision line.  As the week progresses, you may upgrade to your normal diet by the end of the week.

Obviously, this is a very individualized answer.  The average patient is able to go back in public without being obviously swollen or bruised by about 5 – 7 days.

We encourage you to review the section on anesthesia.  The type of anesthesia that is used is determined during the initial consultation.  It is at this time that some patients will express a preference of anesthesia, and we will make certain recommendations based on these preferences.  Most patients have cheek surgery performed under what is called “twilight” sleep.  However, some patients opt for general anesthesia.  All factors are considered including your general health, past anesthesia experiences, and patient preference.