What is it?

Occasionally a person may have a "weak" chin or cheek that does not seem to harmonize with other facial features.   In such cases chin or cheek augmentation can strengthen the appearance of the receding chin or the deficient cheek by increasing its projection.   This can bring the patient's profile into better harmony and give more balance to the overall appearance of the face.

Who is a candidate for this operation?

Any individual who is not satisfied with the shape of his or her chin or cheek. Most individuals seek this operation after the face is fully developed.   This occurs in the late-teens.   In older individuals the only deterrent to surgery may be their general health. Of course like any surgery the most suitable patients are those who have reasonable expectations about the results.

Who is not a good candidate for this operation? There are no real contraindications to surgery unless your health precludes an elective operation. People who have unrealistic goals are not good candidates. An individual who has significant jaw misalignment or poor dental occlusion may or may not be a good candidate depending on the extent of the problem. Your surgeon can tell you if he or she think that a good result is possible in your case.

What does it accomplish?

The shape of the chin or cheek is altered in such a way as to make that structure more suited to your face. Occasionally a person may have a "weak" chin or cheek that does not seem to harmonize with other facial features.   In such cases chin or cheek augmentation (genioplasty, or mentoplasty) can strengthen the appearance of the receding chin by increasing it projection.   This can bring the patient's profile into better harmony and give more balance to the overall appearance of the face. In some people the chin may too big and may need to be reduced. In this case, the chin is reduced by removing the excess bone.

            A cheek implant can be placed under the soft tissues of the cheek in order to augment and give better definition to the cheek.   Sometimes the inadequate projection of the cheek area can be dramatically improved by this simple maneuver enhancing the entire appearance of the person and affecting the way they feel about themselves.   If you have dental occlusion problems this surgery will not change it.

What happens during the first consultation?

In the first consultation you will get a chance to discuss your concerns with our patient care coordinators and Dr, Marefat. We will tell you what you need to know about your procedure and will help you determine what is best for you.   You will receive information booklets and pricing on the procedures.

How is it done ?

For placing chin or cheek implants the incisions are placed inside the oral cavity   (cheek implants) or under the chin (chin implants). In both cases the incisions are very hard to see. Chin augmentation can be performed in two different ways depending on the severity of the problem or the anatomy of the individual.   One method is by actually repositioning the bony end of the chin through an incision inside the mouth.   This piece of bone is shifted to a more favorable position and secured in place with wire or small screws and plates.   After a while the bone heals in its new position and becomes completely stable.   The other technique involves the insertion of a plastic implant over the chin.   This implant can be placed either through an incision inside the mouth or through a small incision under the chin.   In either case the scar is barely visible after a while.

Cheek augmentation can also be done in two ways. One way involves placement of fat in this area to augment the cheek. The other method is by placing a plastic implant over the cheekbone. The advantage of the fat graft is that the fat cells belong to your own body and therefore are not rejected. The advantage of the implant technique is that you do not have worry about losing the fullness of cheek with weight fluctuations and aging.

What are the goals of surgery?

Our objective is to improve the shape of your chin or cheek so that it is more suited to your face.

What kind of anesthesia will I have?  

Generally speaking I like to perform this operation under general anesthesia. In certain, less complicated case it may be possible to do this surgery under straight local or local sedation.

What can I expect after surgery?

Recovery time: After surgery you will have a minimal to moderate amount from the incision site. You will need to rest for the first two or three days, but most people are up and about shortly after surgery. We generally recommend our patients to take off 7 days from work. Heavy lifting and exercising should be avoided in the first two weeks. You body will tell you when you are ready to get back into your regular exercise routine. You will wear a compression garment for a week.   This helps to minimize swelling and limit the fluid collections under the skin or movement of the implants during the critical early days after surgery.   During this interval you can shower normally. There will be some numbness associated with the surgery.   This numbness usually persists for about four to six weeks. A moderate degree of swelling is normal after this operation.   This swelling is related to accumulations of fluid in skin and subcutaneous tissues.   Most of the swelling resides in the first two or three weeks after the surgery.   Minor asymmetry between the two sides of the cheek can be seen after the cheek augmentation.   No one has a completely symmetrical face and you have to accept these minor differences.

Will it be natural?

Unnaturalness in the result of chin or cheek implants is an uncommon. Small irregularities in the contours of your implant may sometimes be visible. Most surgeons are well aware of this and try as best as they can to avoid such visible signs of surgery.   Shifting of the implants is another possible complication that surgeons are aware of and try to minimize by suturing the implants securely in place. However even when everything is done right there is still a chance that you may have irregularity or shifting and you may need to fix this problem in a touch up procedure.   This touch up procedure is done approximately 3-6 months after the initial procedure.

What are some of the complications of facial implant surgery?

Before I tell you about the complications let me tell you a little bit about how to digest these bits and pieces of information. Reading about complications can be quite scary. Many people cannot comfortably sit through a consultation session without having some real doubts about surgery. But it is different when you have these complications explained to you by a Doctor. He or she can put it in perspective for you and tell you the likelihood of such complications. Most complications are very rare. Some are less rare and need to be explained to you in more detail so that you know how we would tackle these problems if they occurred. The purpose of explaining risks and complications is for you to know what steps we take to treat you and put you back on the road to recovery. Remember that every surgeon has his or her own way of treating problems. You must go over these potential risks with your surgeon to gain better insight and understanding.

•  Bleeding. This is very uncommon with facial implants because we are generally not in areas of the face that have a lot of blood vessels. However we have had some reports of bleeding in the literature about this complication. There are those who are at higher risk of bleeding. The use of some medications such as aspirin or coumadin (a blood thinner) could put you at higher risk of bleeding. Some people with history of uncontrolled hypertension can be at higher risk of bleeding after the surgery. There are some individuals who have some problem with their coagulation system that they were not aware of and consequently have had bleeding after surgery.

When and where are touchup procedures done?
Touchups are done after three months. These procedures are usually much simpler than the first procedure and are not as painful.   I can do them in the office with a small amount of local anesthetic solution if it is a minor deformity or problem. However if the problem of the implant were more complicated or difficult to anesthetize, I would do it in the outpatient surgery center under general anesthesia.

When are the sutures removed?

  There are very few sutures in facial implant procedures in general. These usually come out in the first week. Sometimes you may have absorbable sutures that do not need to come out.

How many visits do I have after surgery?

We like to see our patients frequently after surgery. You are seen by the Doctor or nurse within 2-3 days of surgery. Then the normal routine in 1 week, 1month, 3 months.6months, and 12 months. Of course if there is a need you may be seen more. After a year we encourage our patients to come for routine follow-up visits every 3-5 years.

When can I wear make-up?

Yes. You should be able to wear makeup if you have had facial implant surgery. We do not recommend your putting makeup on your incisions however, because this may result in tattooing of the skin by the pigments of the makeup.

Am I a good candidate?

You are a good candidate for facial implant surgery if you have a correctable deformity, normal skin thickness, good general health, and realistic expectations. This does not mean that you cannot perform this operation if you do not meet these criteria. However, the best results are seen in individuals who have moderate skeletal deformities of the chin or cheek with a good quality skin cover. Generally the younger you are the better a candidate you are for surgery. But the physiologic age of person is more important than the chronological age. That is to say you may be 60 years old, but your skin and general health could be better than most who are 50 years old.

What does the surgery cost?

The cost of surgery varies but here are some guidelines that will help you determine roughly what you could expect. Remember that these are only rough estimates . These estimations include the cost of the operating room and the anesthesia. The fee may be subject to change without notice. The best way for you get an accurate cost analysis is to see a doctor.

Chin Augmentation:             $3,500

Malar implants:    $3,500

How do I pay for surgery?

You can pay for surgery by certified check, Credit card, or cash. Payments for cosmetic surgery are expected prior to the procedure. If you are scheduling several weeks in advance of surgery you can pay by personal check.

Are there scars?

Yes. In the case of cheek implants and some chin operations the scars are inside the mouth and therefore not seen. Chin operations are often done through a scar under the chin. In this case the scar is usually 1.5 inches in length and is usually hidden by the natural fold that is present in this area. After several months this scar fades and is hardly visible.

Does it hurt?

The pain involved in chin or cheek augmentation is very tolerable. We have heard our patients describe it as 'soreness' or 'minor discomfort'. Many patients do not finish the pain medications prescribed to them for pain relief. But having said that remember that pain is very subjective, and it is not easy to predict what degree of pain you will have.

Will I be awake during surgery?

These operations are usually done in an outpatient facility under general anesthesia. If you want a good result it is better to let the surgeon concentrate on you nose and not on your level of discomfort during the case.

Where is the surgery performed ? (i.e. office suite or hospital)

The surgery is usually done in an outpatient facility only in rare situations in which the patient may have other risk factors does Dr.Marefat suggest the hospital environment for surgery. Minor touchups and corrections may be done in the office if the area to be corrected can be easily numbed.

Are medical photographs taken?

Yes. In all cosmetic and reconstructive cases medical photos are taken. Photographs are mandatory because this is the only way for us to compare you before and after results. Photographs in plastic surgery serve much the same role that x-rays serve for orthopedic surgery.

Date Revised: 1/23/07

 Copyright © 2004.
  To report any corrections, please contact the webmaster.
  Sitemap