Cheek Implants and Chin Implants

FACIAL IMPLANTS: Cheek implants and chin implants provide your surgeon the ability to create subtle changes in facial contour to enhance a given patient's appearence. Facial implants can be biologic, such as tissue taken from the patient themselves (cartilage or bone), or implants can be produced commercially. For the cheeks and chin, solid silicone works well and have a long success record. When it comes to implants in the nose, however, living biologic material is preferable. Custom implants created for traumatic loss of a portion of the skull (cranioplasty) can be made from a variety of materials.

FACIAL BEAUTY: The main points of beauty of the face are the nose, the cheeks, and the chin. It is the relationship between these prominences which historically has defined facial beauty. This must be balanced with soft tissue structures such as the forehead, the lips, the eyes and the neck. It is this balance in contour that artists and sculptors have been aware of for centuries. Ideal facial proportions were worked out in classical Greek times. Famous Greek sculptors such as Phidias, Praxitiles, Myron, Polycliltis, and others followed rules of anatomic design in order to create their sculptured masterpieces in marble, which are timeless, and continue to be admired today. It is important that Plastic Surgeons have the same artistic skills when it comes to sculpturing the human face.

THE OPERATIONS: Changing the shape of any part of the face requires knowledge of the anatomy and being able to apply that knoqwledge to obtain the best result possible for the patient. For example, cheek implants are generally placed through an incision in the hollow area behind the upper lip where the lip meets the upper jaw. This is called the upper lip sulcus. Once an incision is made, the surgeon must create a pocket by dissecting directly on bone, so as to keep all the soft tissue over the implant. Using special soft tissue elevators, the dissection is angled toward the cheek bone prominence. Once the highest point is reached, an elevator with greater curvature is introduced to extend the dissection aroung the cheek bone (Zygoma). This must be a meticulous and exacting dissection. The nerve of sensation to the upper lip is close by, and this must be protected. A non-reactive implant of silicone which has been chosen by your surgeon for size, is next carefully inserted. The implant has a concave back, so it can conform to the cheek bone. Exltra care must be taken to assure equal placement of the right and left sides. Once properly placed, the wounds are closed, and the patient will be on antibiotics for a number of days to prevent an infection.

Placement of a chin implant is a more simple operation. It can be performed either through the mouth (lower lip sulcus) or through the skin immediately below the chin through a scar that no one sees. If performed through the oral route, there may be temporary muscle weakness to the lower lip. Again, care must be taken to avoid nerve damage, this time to the sensory nerve of the lower lip. In both cases accurate placement of the implant is essential, and the surgeon's artistic judgement must be relied on for size determination. Prevention of infection is paramount; if an inferction were to occur, the implant must be removed in order to resolve it. Displacement of the implant can best be prevented by avoiding trauma or pressure on the area of operation. For example sleeping on the side of one's face after surgery can displace a cheek implant. Once three weeks has gone by the implant will be fixed in position by scar tissue. Knowing the potential risks is important in order to prevent them.

RESULTS: Cheek implants and chin implants are an effective resource to Plastic Surgeons who seek to help patients concerned about contour improvments to their face. The results can be enormously satisfying to the patient accentuating their existing beauty in a subtle but powerful way. For the patient who is considering changing their facial contour for the enhancement of appearence, consultation with a board certified Plastic Surgery specialist is essential. During your consultation, you will become knowledgable about the procedure best suited for you, the alternatives, and the pros and cons of each. For additional information, and to view examples, go to our web page, (http://www.fairbanksplasticsurgery.com/saltlakecity/utah/procedure/facial-implant-surgery/) or call the office at (801) 268-8838 for a consultation. Your surgeons at Fairbanks Plastic Surgery have extensive experience in the area of facial implant surgery.

Fat Injection Grafting

The Procedure

The careful transfer of fat from one part of the body to another is a technique which has become increasingly popular. It has been shown to be effective in correcting defects from areas where fat has atrophied or diminished. An added benefit is that the transferred fat in micro droplets is frequently seen to improve the overlying skin. This is believed to be the result of the presence of adult stem cells in the transferred fat. Only one kind of fat, however, can be used -- it must come from the same person who is undergoing the fat transfer grafting. This is termed autogenous fat as in an autogenous tissue transfer. The procedure is most frequently performed as an out-patient procedure under local anesthesia with sedation.


Where is the Fat Used?

Common locations for fat injection grafting include the lips, cheeks, back of the hand, breasts, and in locations where a patient has been over liposuctioned, leaving a localized indentation. It has been particularly useful in patients who have had a mastectomy for breast cancer followed by irradiation. The tight hard radiated skin will frequently be seen to soften when injected with autogenous fat. It has also been remarkably effective in correcting the atrophic, wrinkled labia majora, giving a full and youthful look.


Comparison to Common Fillers

Autogenous fat grafting must be viewed in perspective and compared to other filler materials of which there are many on the commercial market. The advantages to the use of autogenous living tissue are obvious, nevertheless, a brief review is in order.

1. There is no chance for an allergic reaction or rejection
2. The amount of fat which survives is permanent, living tissue
3. The cost over time is less when one considers the cost of repeat injections of the commercial fillers

Comercial fillers, however, are quite convenient. As everyone knows, the commercial filler materials are heavily marketed. The reason is obvious; there is a financial incentive. No commercial company can market your own adipose tissue (fat). It is therefore expedient for the patient to become knowledgeable and choose what procedure is right for them in the long run.

The advantage of the commercial fillers is that they can be taken off the shelf and injected directly.

Preparation of the Graft

In comparison to the commercial fillers, autogenous fat must be harvested by a non-destructive modality of liposuction (i.e. no Laser-Lipo -- by whatever catchphrase name, such as "Stupid Lipo," and no ultrasonic liposuction; both of which kill fat).

Following the careful harvesting of autogenous fat, the fat must be separated and concentrated so that only pure living fat cells are available to be injected in micro amounts into the living tissues in the appropriate locations. Care is taken to avoid placing a large amount of fat in a single location. The f at must be carefully interspersed in order to insure an adequate blood supply so the injected fat will live. One can expect approximately 50% or more survival of the injected fat by volume in most cases, depending on the care taken during the procedure.

In the Breast

If large amounts of fat are desired -- as in autogenous breast augmentation -- then repeat procedures are necessary to gain the desired volume. By comparison, breast augmentation using a prosthetic implant, is a one stage procedure. Fortunately, each time injection grafting is performed, the patient can expect to have more living tissue, which will then provide an ever increasing blood supply to nourish the newly injected fat.

In the Face and Lips

In the sallow face with wrinkled lips, fat injections are invaluable to plumping up wrinkled and sunken structures and provide a more youthful appearance. This may be combined with an effective dermabrasion to reduce the lip wrinkling. While there is a significant amount of swelling, in a few days the patient will find themselves acceptable to go out in public. By three months, the patient will be able to appreciate their result, even though there will be more swelling to resolve in time. The lips will eventually become soft and natural. If fuller lips is what the patient desires, this may be the best procedure for them.

In the Hands

In the dorsum (back) of the hand, when the tendons are so visible, the skin very thin, and veins appear overly large, fat injection grafting works wonders. There is a definite and predictable change, which occurs in the skin texture. Th aging appearance of the back of the hands gives way to more youthful hands with supple skin. There was a time when the age giveaway on a patient who has been made to look twenty years younger by the deep plane face lift into the release zone, was the appearance of the hands. That problem has been effectively solved by microfat injection grafting.

Are You a Candidate?

If you are considering soft tissue enhancement using filler materials, it is important to understand that your own fat is not only the ideal material, but far superior in comparison to all other fillers on the market. Augmentation of localized defects by fat injection grafting is a highly successful procedure, and can bring lasting satisfaction to patients who choose to proceed in this direction.

Your surgeons at Fairbanks Plastic Surgery have extensive experience in the area of fat injection grafting. If this has been helpful to your understanding about fat grafting, and you wish to learn more, feel free to visit our web site at http://www.fairbanksplasticsurgery.comparison and come into our office for a consultation.