Facial Implants

How is a facial implants procedure performed?

The procedure for placing facial implants follows a similar pattern for all facial areas.

• Surgical markings are drawn on the face to assist the surgeon in implant placement, and to indicate location of underlying structures to avoid.
• The patient is positioned supine (face-up) on the operating table and general anesthesia is administered, along with a local anesthetic.
• The surgeon makes a small incision near where the implant will be placed.
• A pocket is made in the facial tissue in which to insert the implant.
• The implant is gently inserted using a sterilized clamp.
• The incision is closed with sutures and may be bandaged or taped.

1. Cheek implants are placed beneath the eye to create a more sculpted look.
2. Chin implants may help give better balance to your profile.

What are my options?

Facial implants for chin, cheek, jaw, and tear trough are available in solid silicone rubber. Standard four mm commercial shells are suitable to produce natural augmentations in most patients. For a more subtle effect, some patients choose a three mm shell. For patients who desire a more dramatic effect, a five or six mm shell is used. Custom-designed implants can also be created, but are more time-consuming and expensive.

What will my facial implants incisions and scars be like?

Incisions are made near where the implant will be placed:

• On the underside of the chin or inside the mouth at the gum/lip junction for chin implants
• Inside the mouth or through a lower eyelid or brow lift incision for cheek implants
• Around the eyes (transconjunctival or blepharoplasty incisions) or inside the mouth for tear trough implants.

Your initial consultation appointment

During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your surgeon will evaluate you as a facial implant candidate and clarify what a facial implant can do for you. Your goals, medical condition, alternative treatments and additional procedures all need to be considered by you and your surgeon. (See related procedures.)

Patients with gum or dental problems will want to confer with their dentist or oral surgeon. It is imperative that a patient precisely describes for the surgeon the changes he or she hopes to achieve, so the proper implant and implant size is chosen. In addition to current patient photos (and views of the patient when younger), some surgeons require patients to provide examples from magazines or other sources of contour ideals they wish to emulate. A frank discussion between surgeon and patient must occur to determine whether it is possible to achieve the patient’s goals. Some surgeons may use computer simulation programs to show possible alterations and outcomes.

You should come to the consultation prepared to discuss your complete medical history. This will include information about:

• Previous surgeries
• Past and present medical conditions
• Allergies and current medications

Your treatment plan

Based on your goals, physical characteristics and the surgeon’s training and experience, your surgeon will share recommendations and information with you, including:

• An approach to your surgery, including the type of procedure or combination of procedures
• The outcomes that you can anticipate
• Your financial investment for the procedure
• Associated risks and complications
• Options for anesthesia and surgery location
• What you need to prepare for your surgery
• What you can expect to experience after surgery
• Show before and after photos of cases similar to yours and answer any questions, so you can make the most informed and intelligent decision.

Questions to ask your aesthetic plastic surgeon

It is important for you to take an active role in your surgery, so please use this list of questions as a starting point for your initial consultation.

• Am I a good candidate for facial implants?
• Are the results I am seeking reasonable and realistic?
• Do you have before-and-after photos I can look at for the procedure I am undergoing?
• Will my scars be visible? Where will my scars be located?
• What kind of anesthesia do you recommend for me?
• What will be the costs associated with my surgery?
• What will you expect of me to get the best results?
• What kind of recovery period can I expect, and when can I resume normal activities?
• What are the risks and complications associated with my procedure?
• How are complications handled?
• What are my options if facial implants are not for me?

How do I prepare for a facial implants procedure?

Your surgeon will provide thorough pre-operative instructions, answer any questions you may have, take a detailed medical history, and perform a physical exam to determine your fitness for surgery.

In advance of your procedure, your surgeon will ask you to:

• Stop smoking at least six weeks before undergoing surgery to promote better healing.
• Avoid taking aspirin, certain anti-inflammatory drugs, and some herbal medications can cause increased bleeding.
• Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery.

Facial implants are usually performed on an outpatient basis. Be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.

What can I expect on the day of facial implants surgery?
Your facial implant surgery may be performed in an accredited hospital, free-standing ambulatory facility, or office-based surgical suite. Most facial implant procedures take at least thirty minutes to two hours to complete but may take longer.

• Medications are administered for your comfort during the surgical procedure.
• General anesthesia is commonly during your facial implant procedure, although local anesthesia or intravenous sedation may be desirable in some instances.
• For your safety during the surgery, various monitors will be used to check your heart, blood pressure, pulse, and the amount of oxygen circulating in your blood.
• Your surgeon will follow the surgical plan discussed with you before surgery.
• After your procedure is completed, you will be taken into a recovery area where you will continue to be closely monitored. After implant surgery, you will be placed in a surgical dressing that includes a support or compression garment over your face.

You will probably be permitted to go home after a short observation period unless you and your plastic surgeon have made other plans for your immediate post-op recovery.

Short-term post-operative recovery options
Your surgeon will discuss how long it will be before you can return to your normal level of activity and work. After surgery, you and your caregiver will receive detailed instructions about your post-surgery care, including information about:

• Drains, if they have been placed
• Normal symptoms you will experience

How will I look and feel immediately following facial implants?
You will experience post-operative bruising and swelling, with mild to moderate discomfort for a day or two. A cold compress can be applied to the operative site to reduce swelling, bruising and pain. You may be restricted to a liquid-only diet for one or two days. You will most likely be mobile the day of your surgery, but your activities will be restricted.

Recovery time frame after facial implants
It is vitally important that you follow all patient care instructions provided by your surgeon. This will include information about wearing compression garments, care of your drains if placed, taking an antibiotic if prescribed and the level and type of activity that is safe. Your surgeon will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.

The first two weeks

• You should be able to return to work and other normal activities within a week.
• You should recline in a face-up position at a 45-degree angle for at least one week.
• Stitches are removed in five to ten days; sutures placed inside the mouth will dissolve in a similar period of time.
• You may be restricted to a soft diet for up to ten days.

Week two to eight

• After four to six weeks, vigorous physical activity can be resumed.

Facial implants are essentially permanent. All implants can fracture as a result of normal activity or facial trauma. On occasion they can become infected. These problems after facial implant surgery are very uncommon. Most patients can expect a lifetime of improvement after facial implant surgery.

Maintain a relationship with your aesthetic plastic surgeon
For safety, as well as the most beautiful and healthy outcome, it’s important to return to your plastic surgeon’s office for follow-up evaluation at prescribed times and whenever you notice any changes in your facial implants. Do not hesitate to contact your surgeon when you have any questions or concerns.

The cost of facial implants varies from doctor to doctor and from one geographic area to another.

See the national average for physician fees per procedure.
These numbers only reflect the physician/surgeon fees last year and do not include fees for the surgical facility, anesthesia, medical tests, prescriptions, surgical garments or other miscellaneous costs related to surgery.

Because facial implants are an elective cosmetic surgery, insurance does not cover these costs. Many surgeons offer patient financing plans to make the procedure more affordable.

Choose your surgeon based on quality, training, and experience—not cost.

Fortunately, significant complications from facial implants are infrequent. Your specific risks for facial implants will be discussed during your consultation.

All surgical procedures have some degree of risk. Some of the potential complications of all surgeries are:

• Adverse reaction to anesthesia
• Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
• Infection and bleeding
• Changes in sensation
• Scarring
• Allergic reactions
• Damage to underlying structures
• Unsatisfactory results that may necessitate additional procedures

Other risks specific to facial implants are outlined below:

• Contour abnormalities can occur if implants shift or become malpositioned
• Extrusion of implants is rare but can be caused by excessive trauma or infection

You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after your facial implant surgery.