Facial Implant Surgery
Taylor R. Pollei, MD
Fellowship Trained Facial Plastic Surgeon offers facial implants in Beverly Hills and Mission Viejo CA
Basic Information about Facial Implants
At Pollei Facial Plastic Surgery, we provide premier care and technical precision for facial implant surgery at our Beverly Hills & Mission Viejo locations. Before we lunch into any discussion about uses, locations, surgical procedure, etc. it bears mentioning that chin, cheek, temple, and jawline facial implants still have a role despite the expansion of facial filler use. Facial filler has come along way since the early collagen use, and now it consists of many different filler substances with varying lifespans, softness levels, injection indications, and benefits. Still, there are times where facial fillers are either cost prohibitive, we’re just not the best suited for treating certain concerns.
Over the years different implant materials have been popularized, and frequently patients have had personal experiences or close friends or family that had a negative experience with a facial implant. Similar to have breast implants occasionally have issues, need to be removed, rupture, or otherwise become problematic. Having said that, there are definitely still specific situations where the facial implant would do wonders for a patient’s significant concern. Whether this is the placement of a similar implant for mid face wholeness, lateral jaw implant for a very narrow face, or a chin or chin/prejowl implant for weak chin projection.
What Can Different Types of Facial Implants Do For Me?
The goal of the facial implant is to minimize or reverse certain signs of aging or augment specific areas of the facial skeleton. Often if the areas requiring volumization are small, they can be treated with facial fillers. This can include small injection sites on the nose, midface, cheeks, jawline, etc. With facial implants, on the other hand, we are not worried about the improvement fading away in six months to two years since the implant is permanent. Patients typically are aware of the specific areas where they would benefit from an implant. These include patients that have always had very hollow cheeks, a sunken-in appearing midface, a weak chin with poor projection seen on profile view, or patients with an extremely narrow jawline. The goal, in this case, is add volume, be it in small or large amounts to an area of visible deficit and restore a balance between the treated area and other facial features.
How Is A Facial Implant Procedure Performed & With What incisions?
Obviously, this depends on the implant to be placed. Regardless, it is a surgical procedure that requires at least a sedation aesthetic. I prefer ambulatory surgery setting since these procedures can last anywhere from 30 minutes to an hour.
A small, inconspicuous incision roughly 2.5cm long is made horizontally directly beneath and behind the chin. This allows the skin to be lifted off the underlying front part of the lower jawbone. The desired implant shape and size is placed directly overlying the bone, is fixed in place with a single suture. Since the implant is placed into a tight tissue pocket, it does not move or slide following placement. The overlying skin is closed meticulously. The implant I utilize is silicon or Gore-tex, is incredibly well tolerated, and is intentionally selected to be easily removable if it is not desired for whatever reason.
One small incision is made up inside the mouth along the gum line on either side of the cheek. The tissue overlying the cheekbone, right below the most prominent part of the cheek (malar eminence) is lifted up so that the implant can be directly placed on the bone. It is fixated on a single screw that is incredibly small and is covered completely with the implant. Both sides are placed symmetrically, and the small incisions are closed with dissolvable suture.
One incision is needed for each side, with the incision placed on the bottom jaw next to the gum line outside of the teeth. This allows for elevation of the tissue on top of the bone down towards the corner of the mandible. Once completely exposed the implant can be placed directly on top of the bone again with a single very small screw use to secure it in its location. The overlying tissue is then re-draped over the implant. The two small incisions are closed with dissolvable suture.
What is the Preoperative & Day of Surgery Process?
Once you decide to pursue surgery, a lengthy and detailed pre-operative visit is scheduled. This gives an opportunity to review all concerns, answer your questions, review the day of surgery and postoperative instructions, and obtain prescriptions and supplies that will be needed to avoid as much “day of surgery” stress as possible. Consent forms are completed, photographs are taken and reviewed, educational information discussed, and extreme care is taken to make sure both your expectations and mine are congruent.
The surgery itself is performed as an outpatient procedure in my office-based surgery center facility located at the Lasky Clinic (Beverly Hills) or the Crown Valley Surgery Center (Mission Viejo). Patients have a choice of IV sedation or general anesthesia, both have their benefits. The procedure takes less than an hour, depending on the degree of correction needed, and can take longer if additional procedures are being performed.
As with all surgery, nothing is to be eaten from midnight the night before. Immediately preoperatively, the patients face is washed, clothes are changed and after meeting with the anesthesiologist and having an IV started, surgical markings are placed. This is a very important step. Typically the next thing you will remember is waking up in the recovery room following surgery with a gentle dressing holding pressure on the surgical site. Once you are awake and alert enough you are discharged home with a loved one or friend that will accompany you overnight and help you return the next day to the office for you initial postoperative visit.
What Is The Recovery From A Facial Implant Like?
As you wake up in the recovery room, you will be kept comfortable and encouraged to eat and drink as you feel ready. A surgical dressing is placed overlying the chin incision used for placing the implant, but for the cheek and jawline implants, there are no dressings used. This dressing stays in place until your follow-up appointment the next day where wound care instructions are reviewed. Appointments can be made sooner if needed, but at 7 days from surgery, the initial sutures are removed from the chin, while incisions in the mouth heal with the sutures dissolving in the first few weeks. Slight swelling, numbness of the skin, bruising and a feeling of tightness or tension around the surgical site is often felt. Any bruising can be covered immediately with cosmetics after surgery if needed. The chin, check, jawline, or neckline may look puffy, but this is normal! Most of these side effects resolve within days to one week. At the two-week mark, you can return to most physical activity remembering to listen to your body if you are overdoing it! By the three-week mark, scars become less pink and bruising is usually gone. Over the next several weeks, the small single scar becomes less raised and itchy.
If you are looking to combine a neck lift with a facelift, blepharoplasty, chin implant, brow lift, or facial volumization, most patients find a single downtime with recovery better than staging or staggering the procedures.
How Long Do The Effects Of a Facial Implant Last?
The effect of an implant is permanent, but the aging process continues from the time of surgery. I prefer to place an implant that best suits your current expectations but keeps in mind future aging developments. As I mentioned previously although it very rarely occurs I select implants intentionally so that they are very easy to remove if desired. Many older variations of implants were made of substances that were difficult to remove. Fortunately, our understanding of implants and the anatomy behind them has resulted in many fewer needing to be removed. Unlike breast implants, titanium spine implants, joint replacement prosthetics, etc… facial implants do not have a set lifespan, and typically are in good shape for life.
What Are The Risks Of Facial Implant Placement?
Remember as with every procedure discussed here, this is surgery! Any surgeon that downplays or dismisses the potential risks and complications is not being honest and transparent with you. During the consultation and the preoperative visit and detailed review of the risks, benefits, and alternatives to surgery occurs. This allows you to make an informed decision and consent to the surgical plan.
Having said that, implant surgery risks are incredibly low. Occasionally with cheek implants, there can be some irritation of a nearby nerve. This can result in discomfort or abnormal sensation. With all types of implants, there are typical incision-related complications that are possible which can include bleeding, infection, bruising, swelling or persistent visible scar. Also, problems with the general anesthesia or medication taken can be present.
Contact our practice to learn more about facial implants, including chin implants, where we serve the Beverly Hills, Mission Viejo, and South Orange County areas.