Malarplasty is the medical term used to describe the augmentation or general reshaping of the cheeks and jaw. Cranial facial surgery, a more serious type of procedure, is performed to correct misshapen jaws or facial asymmetry due to a congenital abnormality or a serious illness or injury.
In cheek and jaw augmentation surgery, implants are used to change the underlying structure, which affects the overall balance of facial features. Often cheek implants are used together with other facial implants, particularly chin implants, however, they can be used alone. These procedures are often performed in conjunction with other cosmetic procedures such as facelift, nose surgery, eyelid surgery or chin surgery. Cheek and jaw implants are made in various shapes and sizes and are made out of both solid and semi-solid materials.
What happens during the procedure?
The procedure is usually performed in an outpatient surgical center, either operated by your surgeon or a hospital facility, and takes between 30 and 60 minutes, but depending on the extent of the procedure, it can take longer. If you are having more than one procedure, overnight hospitalization may be required.
Cheek and jaw augmentation can be performed under local anesthesia, along with intravenous sedation. General anesthesia may be advised depending on your health, the extent of the procedure and whether you are having other procedures at the same time. Before your surgery, routine laboratory tests may be requested including blood counts and blood chemistries.
Cheek augmentation involves placing the implant over the cheekbone through an incision made inside the mouth or through an opening just beneath the lower eyelash. The incision blends with the lash line and is nearly unnoticeable. The surgeon creates a pocket in the tissue and then inserts the implant. The implant is placed directly on or below the cheekbone. Incisions are closed with sutures (stitches) that dissolve in a week or two. In some cases a small titanium screw may be used to attach the implant to the bone. After surgery, a dressing will be applied to minimize discomfort and swelling.
Insertion of a jaw implant usually takes about one to two hours. Incisions are made inside the mouth on either side of the lower lip. The surgeon creates a pocket into which the lower-jaw implant can be inserted. The incisions are closed with dissolving stitches.
Are there risks or potential side effects?
As with all surgeries, there is always a possibility of complications following facial implant surgery, including infection, a reaction to the anesthesia, hematoma, seroma, bleeding, extrusion (the implant works its way back up to the skin’s surface), capsular contracture (excess tightening of the scar tissue) which may distort the implant, asymmetry, nerve damage and bone erosion.
If the surgery involves an incision inside your mouth, it is important that you inform your physician if you smoke or if you have any dental or gum problems.
Sometimes, a facial implant can shift slightly out of alignment and a second operation may be necessary to replace it in its proper position.
Should infection occur, your surgeon will prescribe a treatment with antibiotics, however, the implant might have to be temporarily removed if the infection does not clear up and replaced at a later date. Other, less-common risks may be associated with certain implants. Be sure to ask your surgeon about all of the risks associated with the procedure you are considering before you make any decision.
What to expect post-procedure?
The extent of the post-operative swelling and bruising is dependent on whether you tend to bruise or swell easily. The amount you can expect varies for each individual but past surgeries or injuries should be a good indication. After jaw implant surgery, swelling is sometimes significant and usually peaks 24 to 48 hours afterward. Although most of the significant swelling will subside over a period of several days, prolonged mild swelling may prevent your final facial contour from becoming apparent for several months.
There can be numbness and/or stiffness as well as pain and discomfort for a few days following facial implant surgery. You doctor will prescribe medication to alleviate it the pain and to fight infection.
Keep your head elevated, above heart level, when lying down. Applying cold compresses, or small ice packs will reduce swelling and relieve discomfort. Many patients use a water-tight plastic sandwich bag filled with an ounce of frozen berries or peas. Regular icing is the key to relieving the swelling
Some difficulty talking and smiling for several days following the surgery is normal. Patients with intra-oral sutures are sometimes placed on a liquid diet for several days until there is enough healing for food particles to come in contact with the stitches. Your surgeon will instruct you about dental hygiene, eating and any restrictions to your activities after surgery and it is important that you follow all of his or her instructions to minimize risks and help speed-up your recovery.
How soon does normal life resume?
Within the first week, you can be back at work. Although you should avoid strenuous activities, exercise can be resumed in about two weeks. Be careful to avoid contact sports or any activity that may result in the face being jarred or bumped for several weeks. Check with your surgeon about resuming such activities. Although most of the significant swelling will subside over a period of several days, prolonged mild swelling may prevent your final facial contour from becoming apparent for several months.
Who performs it?
Cheek and jaw augmentation surgery is usually performed by a plastic surgeon or an otolaryngologist (ENT).
Are you a good candidate?
As with all elective surgery, good health and realistic expectations are prerequisites, but if you want to change the shape of your face or are having a facelift, eyelid or nose surgery, then cheek or jaw augmentation surgery may be appropriate, but:
Make sure that you are free of known allergies to the implant material.
Tell your surgeon about of any and all medical conditions and any allergies you may have and whether you are a smoker or have dental or gum problems. Also, tell your surgeon about any medications, herbal supplements or natural supplements you are taking (both prescription and non-prescription).
Make sure you are not prone to scarring problems such as keloids.
Make sure you have a good understanding of the healing process and the limitations of the procedure.
How to prepare for surgery?
Your doctor will give you specific instructions to prepare for surgery but here are some general guidelines:
- Avoid aspirin, any aspirin containing medication or any other non-steroidal anti-inflammatories (NSAID), such as Motrin® or Advil®, for two weeks prior to treatment. Because aspirin thins the blood, it can interfere with normal blood clotting and increase the risk of bleeding and bruising.
- Smoking inhibits the healing process, so stop smoking before your procedure and if you start again, make sure it is after you are completely healed.
- Avoid drinking alcohol a few days before your surgery.
- Make sure to follow any fasting instructions the night before and morning of your surgery. Your doctor may insist on an empty stomach depending on the type of anesthesia.
- Make sure that you arrange for someone to bring you home and to help you out for 24 hours after surgery.
Are there alternatives to this procedure?
An alternative to cheek and jaw augmentation surgery is orthodontistry, which can treat a malloclusion and misaligned teeth and can significantly change the overall shape of the face.
WHAT IS BIO-ALCAMID®?
BIO-ALCAMID® is an injectable product that is an absolute innovation in the medical sector. For the first time, medical science can employ a product comprising 96% water and 4% synthetic reticulate polymer ( poly-Alkyl-Imide ). This blend guarantees softness to the touch; the implant has a similar consistency to the surrounding tissues without causing unsightly visible or palpable effects of artificiality.
WHERE IS BIO-ALCAMID® USED?
BIO-ALCAMID® is used to correct all types of secondary imperfections caused by soft tissue deficit, in post-traumatic injuries and post-surgery scars, serious congenital facial and body microgenia and also cosmetic applications.
BIO-ALCAMID® is also the ideal implant for defining the lip outline and correcting volumetric face deficits of the cheekbones, chin, jaw etc… Unlike other fillers, BIO-ALCAMID® can be used to correct severe and large soft tissue deficits without any risk due to its biocompatibility.
HOW LONG DOES BIO-ALCAMID® LAST ONCE INJECTED?
Under general physiological conditions BIO-ALCAMID® is a definitive implant like any other artificial prosthesis. The visible effect created by BIO-ALCAMID® is that of youth, but with the passage of time, the skin ages and the tissues (especially muscle tissue) change position and shape creating new imperfections and anomalies in spite of the “mechanical support” provided by BIO-ALCAMID®. However, the appearance of aging is easily corrected with the addition of more BIO-ALCAMID® in the areas in which it is needed.
IS THE IMPLANT PAINFUL?
Locally injected anaesthetic substances, such as lidocane or a topical numbing agent, can be used to reduce the discomfort of the injections. Areas with BIO-ALCAMID® implants are generally not painful after procedures have been completed.
CAN THE IMPLANT BE DONE AT ANY TIME OF THE YEAR?
Yes, although it is advisable to avoid exposure to direct sunlight or tanning bed facility for at least a month following the implant; this is to prevent possible alteration of the secondary pigmentation in the temporarily inflamed area caused by the implant.
CAN ANYONE GET BIO-ALCAMID® IMPLANTS?
Studies conducted to date have proven that BIO-ALCAMID® is a safe product; it does not require a sensitization test as no allergic reaction has ever been reported. However, it is advisable to inform the presiding physician regarding any tendency to allergic reactions (“polyallergic” subjects).
WHAT HAPPENS AFTER THE IMPLANT?
Immediately after the introduction of BIO-ALCAMID®, a thin, natural, physiological capsule is formed. This encloses the substance forming an actual prosthesis that can, if necessary, be easily identified and removed. The swelling that develops immediately after the implant is minimal under normal conditions. Immediately following the injection, there is a slight reddening in the area, but this disappears after a few minutes. There is additional swelling a few hours after the procedure is completed. The positive (acute) self-controlled inflammatory response begins within a few hours and ends approximately 8 weeks later when the encapsulation process is complete. The resulting appearance of the implanted areas improves with each passing day. Upon the encapsulation being complete the overall effect is natural both in appearance and to the touch.
IS BIO-ALCAMID® A SAFE SUBSTANCE?
Clinical and laboratory analyses show that BIO-ALCAMID® is non-toxic, non-sensitizing, non-mutagenic, biocompatible, permanent, removable, and physically and chemically stable. In addition BIO-ALCAMID® is radio-transparent allowing for differential diagnosis when there are other structures present in the implanted area. Years of strict and scrupulous clinical experimentation have allowed BIO-ALCAMID® to receive the CE mark by the official European authorities for the maximum in safety and product quality control.