Facial bone structure plays an important role in a beautiful, proportional facial contour. When evaluating the facial aesthetic proportions, forehead, nose, cheekbones and chin proportions are mainly taken into consideration. The bone structure of a beautiful face must be harmonious from a proportional point of view.
The nose, cheekbones (malar bones) and tip of the chin are the most significant facial characteristics in front and side view. Facial implants are successfully used to correct the asymmetries, bone deficiencies of the cheeks and the chin especially, and to create a more aesthetic contour to the face. While in the past these surgeries were performed with cartilage and bone grafts from the patient’s own body, technological advancements made it possible today to reshape the body with preshaped implants, without damaging another of its areas.
Implant materials are produced after long and meticulous research, designed to stay in the patient’s body for life; they are nonetheless easily removable when they are not desired anymore, reversing the process. Today, MEDPOR® and rigid silicone implants are used without issue.
When evaluating chin and tip of the chin-related issues, closing of the mouth is also considered. When the way teeth fit is not ideal, it can be treated first with an orthodontic treatment, and if necessary, orthognathic surgical procedures to correct jawbone defects and closing of the mouth are suggested. When there is no teeth fitting-related issue and the only subject is related to the tip and/or sides of the chin, appropriate implants will be chosen and applied.
Generally, a small pocket is created inside the mouth with an incision. A prosthesis of the desired size and shape is chosen and placed inside. Depending on the pocket, the implant can be located and immobilized with small screws. There are also facial implants designed for the sides of the chin and used the same way as the tip implants. The procedure is most frequently done under general anesthesia. The operation takes approximately one hour. After the operation, the chin is immobilized with dressings which will be taken out 3-4 days later. It is suggested to follow a soft food diet, avoid hard foods and use mouthwash frequently during the first days following the operation. During the same period, sensitivity, edema and numbness in the lower lip may be experienced, however they will heal shortly. Infection may rarely be observed in early stages. In addition, in later stages the prosthesis can move or its edges can be felt through the skin if it has not been immobilized; then the prosthesis should be rasped, or replaced.
When evaluating cheekbones, upper chin development is studied. Malar implants are used when the issue is limited to the size and position of cheekbones, while orthognathic surgery will be considered in case of general insufficiency of the upper chin and difficulty closing mouth. In mild deficiencies of cheekbones and general mid-face area, fat injections may be scheduled. Malar implant procedures are very effective for cases where a more significant change and remodeled appearance are desired.
They are usually placed from the mouth. The operation takes approximately an hour, no severe pain or discomfort will be expected. The recovery is fast. Although rarely, implants may move or cause reactions. In these cases, planning an additional surgical intervention may be necessary.