Anatomically and topographically, the cheekbones represent the most prominent zone of the upper and outer parts of the cheek (they are “above the cheek”) and they are very aesthetically important for the face as a three- dimensional structure. The Latin name for this region is Regio Zygomatica and it actually corresponds to the projection of the zygomatic bone(cheekbone). However, the shape, size and position of the cheekbone is not determined only by the bone’s structure, but the structure of soft tissues above it as well (subcutaneous fatty tissue, muscles, skin).. Certainly, each person’s cheekbones are different, not only in size and shape, but in position as well. These traits were found to be genetic, but they are subjected to changes which can be caused by periods of weight gain or loss, some diseases, as well as the aging processes.
Augmentation and correction of cheekbones can be achieved in 4 different ways:
- by placing cheekbone implants (made of hard silicone or Gore-Tex)
- cheekbone osteotomies
- by injecting a filler (temporary or permanent)
- by injecting the patient’s own fat
Also, it is possible to combine these methods.
PREPARATION AND OPERATION
If the operation is performed with general anaesthesia, then the usual preoperative preparation is necessary. Sometimes, in order to plan the operation and select the implant, it would be useful to do a X-ray of the zygomatic region or a scanner. When planning the operation, regardless of whether it is an implant, filler or fat correction, it is crucial to precisely and accurately determine the position of the implant, i.e. the location where the substance will be injected. Special attention should be given to the following three zones:
- zone directly above the cheekbone and above the front third of the cheekbone arch (the cheekbone in the narrow sense)
- zone of the middle third of the cheekbone arch (when the patient need a “lateral augmentation”)
- zone of subcheekbone triangle (in patients with “hollow cheeks” directly under the cheekbone)
When cheekbone augmentation is with implants, then the procedure is performed with general anaesthesia.The most common approach is the so called intraoral approach, which means that the implant is inserted through a small incision on the mucous membrane of the upper lip and along the upper edge of the gum, so the final scar is virtually invisible. The second option, which is technically more complicated, is to insert the implant through an incision on the lower eyelid. When the correction is done with fillers or patient’s fat, then local anaesthesia is used with possible intravenous analgosedation. The injection is done with special thin cannulas or needles, so there are no scars.
After the intervention, exposure to the sun is not recommended, as well as strenuous physical activities during two weeks. It is recommended to sleep on the back so to avoid treated regions compression. Smaller or bigger swelling is almost always present, as well as bruising. Possible complications are infections, asymmetry, hypercorrection or hypercorrection and dislocation of implants. The result obtained by implants can be considered lasting, although not life-long, and the result obtained by some of the fillers will last depending on the used filler (temporary, semi-permanent, permanent).