Cheek augmentation

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Cheek augmentation (malar augmentation) is a cosmetic surgical procedure that is intended to pronounce the cheekbones in a person's face.

In western culture, prominent cheekbones have long been a sign of beauty in both men and women. The cheek bone is technically called the zygoma, and it is a bony arch that extends from near the ear to near the nose. The relative prominence of the zygomatic arch is an individually inherited feature, that, like many inherited facial features, tends to have certain shapes and positions in ethnic and racial groups. Sometimes prominent cheekbones (also called "high cheekbones") are a characteristic feature of a group, such as Native Americans (American Indians). Even within such a group, a large range of individual variation exists. Interestingly, in some Asian countries (for example, Korea), where the average native born person has prominent cheekbones by western standards, particularly prominent cheekbones are considered unattractive, rather than valued as a mark of beauty.

## Development of malar augmentation[edit]

As a cosmetic enhancement, some of the first malar augmentations were done in the 1960's with injections of liquid silicone, in both Europe and the United States. Initial results were usually good, but, after weeks, months, or years, the silicone material began to disperse in the face. Instead of the sculpted appearing mound accenting the cheekbone, patients had this filler material making bulges and creases that marred the aesthetic appearance of the lips, nose and other areas of the face. Since the material did not drift exactly identically on each side of the face, the appearance was further hindered by asymmetry of the enhanced cheekbones, which might be prominent on one side (or a portion of one side), and not the other. Additionally, there were systemic complications that caused illness and even death, if liquid silicone was inadvertently injected into the bloodstream. Injections of liquid silicone for soft tissue augmentation is not approved by the US Food and Drug Administration (FDA).

## 1970's[edit]

By the 1970's, the problems with liquid silicone had become apparent and alternative methods established. The first synthetic malar implants were also silicone, solid silicone blocks- handcarved by the surgeon (T. Rees-Aesthetic Plastic Surgery.Volume II, page 822)

A plastic surgeon will usually make an incision in the upper mouth near the top of the gum line and slide the implants into place. Another method is to make an external incision near the eye, but most patients do not prefer this method since it can create a visible scar. However, the intraoral (inside the mouth) approach carries a higher risk of infection since the mouth contains more bacteria.

Cheek implants can be made of different materials, and come in many different sizes and shapes depending on what the patient wants. The most common is solid silicone, however other materials can be used as cheek implants. The second most popular material is expanded polytetraflouroethylene (ePTFE), which is known to integrate well with internal tissue to prevent the implant from shifting out of place. Bone grafting can also be used to build up an individual's cheekbones as well as coral and other less common materials.

Cheek augmentations are usually performed under sedation or general anesthesia and take about one to two hours. Recovery from this surgery usually takes about ten days.