CHIN & CHEEK AUGMENTATION
 

Facial Augmentation: A Permanent Solution to Loss of Volume

Throughout different cultures and times concepts of beauty may change. But it is unequivocally recognized that young faces that are fuller, are more attractive. In the early part of the century, procedures for rejuvenation of the face were aimed at counteracting sagginess and removing excess skin. It is only in the recent decade or two that it has become evident that with aging, there is a loss of volume in the face that contributes to sagging. In addition, there are some facial contour deficiencies that can only be corrected by addition of volume.

Currently there are many options of fillers that can add volume to the face. For example, Collagen, CosmoDerm, Hylaform, Restylane, Sculptra, Captique, etc. are some of the available fillers on the market today. The oldest filler available is “fat” (see Fat Augmentation) which can be obtained from some other part of the body. Unfortunately, most of these fillers are only temporary and last anywhere from a few months to a couple of years. An alternative, simple and permanent way to add volume to the face is by placement of facial implants. The most commonly used facial implants are cheek implants, chin implants and jaw-line implants.

Cheek Augmentation:

High cheekbones are generally considered a sign of beauty, giving the appearance of elegance, youth and vitality. Famous figures such as Bo Derek and Raquel Welch have facial contours that many have desired over the years. One way to create an illusion of high cheekbones is through the application of cosmetic makeup. After time, makeup may not be sufficient to create that illusion. Surgery to insert implants in the cheek area has become more popular in today’s society. This surgery can give definition to a face that has a flat contour due to underdeveloped cheekbones, or replace lost volume in the midface. It is also done to correct facial defects or asymmetries. It may be performed in conjunction with other facial procedures such as eyelid surgery, browlift and facelift.

The procedure is usually performed on an outpatient basis. Although there are different approaches to placement of the cheek implant, the best and least invasive is placement through a small incision inside the mouth, which leaves NO scars on the face. The implants come in a large variety of shapes and sizes, so that the proper one can be selected for each individual. The implants are carefully designed to fit the skeletal form resulting in a very natural appearance. Most are made of Silastic, a soft inert material that has been found safe for implantation. Some temporary swelling and bruising of the face are to be expected and resolve spontaneously within a few days.

CHEEK AUGMENTATION

Chin Augmentation:

The Chin has also been considered a sign of physical beauty throughout the ages. Some individuals who exhibit “weak” or receding chins, their faces may seem unbalanced to them. Chin augmentation, or mentoplasty, is a surgical procedure that has helped thousands improve their appearance by altering the contours of their faces. The best candidate for chin augmentation is the individual with a receding chin and a normal dental bite. For those with a bite dysfunction, jaw surgery, in conjunction with mentoplasty, may be necessary. In some cases, a chin augmentation is done in conjunction with liposuction or other cosmetic facial procedures such as rhinoplasty and facelift.

When it comes to profiles and facial balance, a chin implant plays a very important role and is usually brought up in the discussion with the patient. This procedure is also done on an outpatient basis. The incision is made either inside the mouth or externally, under the chin. The implant, sized exactly to fit the patient, is placed in a pocket above the chin bone and beneath the muscles. Recent improvements in the design help augment the chin giving the patients a very natural result. Patients are up and around the day of surgery, however, strenuous activities must be avoided for some time.

CHIN AUGMENTATION WITH RHINOPLASTY

Facial implants are a permanent way of restoring lost volume and proportion in the face through minimal incisions and minimal scars with a fairly quick recovery.

 

Fat Augmentation:

People have always tried to improve their appearance since the beginning of civilization. Disfigurement of the skin has been particularly distressful for many. With the advent of new fillers there are excellent procedures available to correct such skin defects such as deep furrows and wrinkles on the face. Depressions on other areas of the body can also be corrected through a procedure called autologous (from the same individual) fat transplantation. This procedure can help contour the face, enhance the cheek and chin and correct facial or body deformities.

Fat is removed from a donor site and then re-injected into the recipient site. This can be done under local anesthesia or IV sedation (twilight sleep). The process is repeated until the desired amount of fat has been transferred and the defect is corrected.

With this procedure, problems of rejection or allergic reactions are not factors, because the fat is transplanted within the same body. Recovery time is very short and patients are usually up and around the day of surgery. The only downside of fat grafting is that some of the fat may dissolve and the patient may need additional fat grafting procedures to achieve the desired contour.

Fat grafting is a way of restoring lost volume and proportion in the face through minimal incisions and minimal scars with a fairly quick recovery.

— Los Angeles Health News January 2006
 

 

Lip Augmentation:

Fuller lips are a sign of youth and sexuality. Women accentuate their lips with lipstick. Unfortunately, with aging the lips atrophy and become thinner. Some develop lines and wrinkles around the lips as well. There are multitudes of ways to achieve fuller lips. A simple way is by injecting a filler such as collagen (Zyderm, Zyplast, CosmoDerm or CosmoPlast). The major advantage of collagen is that it can be implanted as an office procedure and requires minimal recovery. The results are apparent immediately, although there is some initial swelling that resolves with in twenty-four hours. The injections are relatively painless since a local anesthetic is incorporated with the collagen implant. The major disadvantage is that the effect is not permanent. The body slowly absorbs the material over a period of three month at which time a touch up injection is recommended.

There are a number of fillers that are made of hyaluronic acid which is a natural substance that already exists in the human body and is used to provide volume and fullness to the skin. Restylane, Hylaform and Captique are all hyaluronic acid based products that have been approved by the FDA. Their effects generally last about six months. Since a local anesthetic is not incorporated in these products the patient may need application of numbing cream or an injection of lidocaine prior to the augmentation.

To achieve fullness at the vermilion (the border of the lip) and the body of the lip the combination of a form of collagen and hyaluronic acids works effectively and our patients have been extremely pleased.

Fat injections can also be used for lip augmentation. Small amount of fat harvested from some other part of the body can be injected in to the lips. The advantage of fat it is autologous (from self) and therefore there is no chance of sensitivity or allergy. Disadvantages are that fat in the lips tend to dissolve over time and repeated injections are necessary.

There are also a number of materials that can be implanted in to the lip. AlloDerm is processed human skin that is rendered immunologically inert by a special process that removes its antigenic components that can lead to rejection. It was originally developed for treatment of burn victims. Unlike the other injectable fillers the AlloDerm implant is replaced by patient’s own collagen and seems to last longer. The insertion of the implant involves a small surgical procedure where tiny incisions are made at the corner of the lips and the implant is rolled in to the upper and lower lips. With this procedure the patient should expect more significant swelling for the first few days and therefore more downtime.

Another material that can be used to augment the lip is Soft Form also known as UltraSoft. UltraSoft facial implant is a soft, tube-shaped implant made of a biocompatible polymer called ePTFE.  This material is similar to GoreTex (but is much softer) and has been   safely used for more than 20 years in a variety of medical applications including blood vessel replacement and hernia repair.  Placing this permanent implant beneath the skin can enhance and define the lips.