Cheek enhancement surgery, also known as cheek augmentation, is a procedure that aims to add volume to the cheeks to create a fuller, more youthful appearance. It is popular with people that feel they have flat or thin cheeks. This may be due to their natural face shape or as a result of ageing.
30 mins to 60 mins
Day case or one nIght
2 to 3 months
This surgical procedure involves the use of either implants or fat grafting to enhance the cheek volume.
What can a cheek enhancement achieve?
A cheek enhancement aims to add volume to the cheeks through either implants or fat grafting. By adding volume to the cheeks, it can create a more youthful appearance. In addition, a cheek enhancement can also help improve the proportions of the face, particularly if patients feel their cheeks are too small for your nose and chin. The enhancement can be tailored to the facial shape through the use of different sized implants to achieve the most aesthetically pleasing result.
Patients may choose to have cheek augmentation surgery if they:
- Feel the cheeks appear thin or sunken
- Want to restore a loss of volume due to ageing
- Feel the cheeks are too small for the nose and chin
Who are the ideal candidates for a cheek enhancement?
Cheek enhancement surgery may not be for everyone for several reasons. Ideal cheek enhancement candidates include those who are:
- Lacking volume in their cheeks either due to their natural face shape or as a result of ageing
- Wanting to enhance the proportions of their face
- Willing to continue a healthy lifestyle after surgery
- Non-smokers or are prepared to not smoke for at least 6 weeks before and after the surgery date
- Realistic with their expectations
- Emotionally prepared to have surgery
Why have a cheek enhancement?
Different people have varying amounts of fat within their cheeks. This fat typically adds volume to the face and is associated with a more youthful appearance. Someone may want to have a cheek enhancement for a number of reasons. They may find that their face is naturally thin or have lost volume as a result of ageing. This lack of volume can make people feel as though they have a hollow or sunken appearance. Adding volume to the cheeks naturally can be very difficult without gaining weight elsewhere on the body. Therefore, people may choose to have a cheek enhancement to restore this volume, creating a fuller facial appearance.
Alternatively, some people find their cheeks are out of proportion to the rest of their facial features, such as the nose and chin. A cheek enhancement will help improve these proportions to create a more balanced facial shape.
A cheek enhancement can:
- Add volume and create a fuller facial appearance
- Create a more youthful appearance by restoring hollow cheeks
- Improve facial proportions
- Boost self-confidence
What to expect during the cheek enhancement consultation?
The cheek enhancement consultation will typically last 15 minutes to one hour. During the consultation, the surgeon will discuss all aspects of the surgery. Some important topics they should cover include:
- Motivations to have a cheek enhancement
- Expectations and desires
- Advice on how to achieve the best results
- The risks and complications of the procedure
- Potential non-surgical options, if appropriate
After discussing the details of the cheek augmentation. The surgeon will ask about medical history. This will include:
- Current health status
- Past or current medical conditions
- Medications that you are currently taking including herbal remedies and vitamins
- Use of alcohol, tobacco or recreational drugs
- Drug allergies
- Previous surgeries.
The surgeon will also examine the patient's face and take photos of them for the medical records. They will then present procedure options. The surgeon will base these options on:
- The best surgical approach to the problem the patient has expressed
- The amount of volume to be added to the cheeks
- Personal preferences
Questions to ask during the cheek lift consultation
It is very important that patients fully understand the procedure. This consultation provides the opportunity to discuss any feelings the patient has about the surgery, and ask any questions such as:
- Do you think that what I want to achieve from surgery is realistic?
- What will you expect from me to get the best results?
- How will you perform my procedure?
- Where will my scars be located?
- How long will the recovery period be, and what kind of help will I need in this period?
- Have you performed this surgery before?
- Is it possible to see photos of similar operations you have done?
- Do you think my goals could be achieved with non-surgical options?.
How to prepare for a cheek enhancement?
To improve the experience of the procedure there are certain things patients should consider doing in advance. The surgeon will give specific advice on what to do prior to having the surgery. Some of the cheek enhancement preparation tips that are recommended include the following:
Patients may find that after surgery, it may be more comfortable to prop themselves up while they sleep. Patients can help this by having extra pillows ready for the day after the surgery.
Patients should try to avoid bending over as this may strain any stitches. As a result, patients may find it useful to put any items on lower shelves on the kitchen counter. This stops them from having to reach down to get them.
Be sure to do a food shop prior to heading into the hospital. This will allow patients to find and prepare suitable foods they can eat after the operation. Patients could also prepare some meals to put in the freezer so that they do not have to worry about cooking.
Children & pets
As patients will need plenty of time to rest and recover, they should ask family and friends to help look after children and pets for the first week or so after the operation.
It may be useful to clean the house, do the washing and take the bins out before the operation. This will give you more time to recover.
Patients will not be able to drive straight after the operation. They should, therefore, ask a family member or friend to take them home.
It will help the recovery process if the patient maintains a healthy diet. Try to have lots of protein, vegetables, and water. Try to avoid citrus or acidic foods for the first 3-5 days after the operation. These may irritate the incisions.
Be sure to have some comfortable, loose-fitting clothes to wear after the procedure. It's advised to wear clothes that can easily fasten from the front to avoid straining the incisions.
If patients smoke, try stopping for at least 6 weeks before and after the operation. Smoking can slow down the healing process and increase the risk of complications. As a result, it is very important that patients give up during this time to help ensure the surgery goes as smoothly as possible.
The BAAPS/BAPRAS surgeon will give specific advice regarding how to prepare for the cheek enhancement. It is vital that patients follow their advice.
Before the surgery please discuss any medicines being taken with the surgeon and/or anaesthetist. This includes over the counter medications, herbal remedies and any other drugs not prescribed by a doctor. It is important to follow any instructions about adjustments to medications or medications that patients have been told they should stop prior to the surgery. This is particularly important if patients are taking any blood-thinning medications such as warfarin or clopidogrel and/or any oral diabetes medications.
The Cheek Enhancement Procedure
How is a cheek enhancement performed?
The cheek enhancement procedure usually takes between one to two hours. It may be done as a day case but usually requires a one night stay in the hospital. Before patients come in for their cheek enhancement, patients must follow their surgeon’s instructions for eating, drinking and taking medications the night before the surgery.
Cheek enhancement surgery involves the following steps:
Patients will have to sign a consent form before having their surgery. They will sign this either on the day of the surgery or during the pre-operative assessment a week before. It is advised that patients take the time to read the form carefully. This is in order to ensure that they fully understand all the risks, benefits and potential complications of the surgery. Also, be sure to ask any questions that remain unanswered before signing the consent form.
After patients sign their consent form, the surgeon may want to have a look inside the mouth or draw some lines on the cheek. They will also discuss the goals of the procedure and what they will be doing.
The anaesthetist will then administer the anaesthetic. For cheek augmentation, patients can either have a general anaesthetic or local anaesthetic with IV (intravenous) sedation. The type of anaesthetic the patient is given depends on the surgeon's practice, this will all be discussed in the consultation
After the anaesthetist gives the anaesthetic, the surgeon will clean and put drapes over the surgery area before making the incisions.
The incisions for cheek augmentation are made inside the cheek at the positions marked in blue in the photo below.
This allows the scar to be hidden inside the mouth. If fat is being taken from the stomach area, a small incision will also be made in the belly button. There are two techniques for cheek augmentation that the surgeon may use.
In this cheek enhancement procedure, the surgeon takes fat from an area (liposuction) such as the stomach or thighs and transfers it to the cheeks. This procedure has the added benefit of removing unwanted fat from the body. Patients that do not want to use artificial implants may prefer this procedure.
Alternatively, the surgeon may use implants instead of fat from the body. This technique uses the same approach as fat grafting but may give more predictable results. The surgeon uses implant sizers to ensure the best-sized implants for the cheeks. Using implant sizers helps to achieve the best result and most natural appearance. Incisions shown in blue in the photo above are located inside the mouth so there are no visible incisions on the face.
The surgeon will discuss the different techniques and suggest which one will achieve the best results for the patient's face. The BAPRAS/BAAPS surgeon’s choice will depend on a number of factors. This includes the amount of volume to be added to the cheeks as well as the patient's preferences.
Closing the incisions
The surgeon closes the incisions using dissolvable stitches. In addition, they may give you a facial support garment to help reduce any movement post-operatively. The patient may also have some small drainage tubes put under the skin to help reduce swelling and bruising. Usually, the surgeon will remove these drains before the patient goes home.
Return to the ward
After the cheek augmentation procedure, the patient will recover from the anaesthetic on the ward. They may be able to go home on the same day but it is likely that they will have to spend one night in hospital following the procedure. Patients should then be able to go home to rest the next day.
What to expect after a cheek enhancement?
Following the operation, they will have a post-operative appointment arranged. This is usually 1-2 weeks after the operation. During this appointment, the surgeon will examine the face and discuss any potential complications. They will also look at the incisions and remove any stitches if necessary.
Eating and drinking
After the cheek enhancement, patients may find it difficult to eat solid foods. As a result, it is recommended that they stick to liquid or softer foods for the first few days. It is also important to avoid acidic or citrus foods for the first few days. As the incisions are made inside the mouth, these foods can irritate the incisions and slow down the healing process. After the first 3-5 days, patients should be able to start going back to their normal diet.
As the incisions are made inside the mouth, there is no visible scar on the cheeks. However, it is still important to ensure patients look after the incision site to help the healing process and avoid complications.
There are a number of techniques that the surgeon may recommend that can aid the healing of scars following surgery:
- Rinse the mouth out after every meal, this will help prevent food from irritating the incision site.
- If patients smoke, they should be sure to stop smoking at least 6 weeks before the surgery and continue to stop for at least 6 weeks after the operation. This is very important in helping the healing process and reduces the risk of infection.
Returning to work
How quickly patients can return to work will depend on the nature of the job they have. For office-based work, it is suggested that patients take around 7 days off work. For more physical jobs they may need around 7-10 days off. During this time it is important to avoid any straining or heavy lifting. This will help to ensure the healing process is as smooth as possible.
Returning to sport and exercise
Feeks 4-6 following any operation, it is important to gradually ease back into physical activity. It is suggested that patients follow these guidelines:
During the first week, patients should avoid doing any sport or aerobic exercise. At this stage, it is important to focus on the healing process and avoid anything that may cause staining of the face. Patients should, however, be able to resume light aerobic activity such as walking on a treadmill.
At this stage, patients will be able to return to more vigorous exercise such as running and cycling.
Week 4 to 6
Around four to six weeks after the operation most of the healing should have taken place. As a result, patients will be able to try body contact sports and workouts again.
Depending on the advice that the surgeon gives, patients may not be able to drive for a period of 5 days to 2 weeks after the surgery. Patients should, therefore, make sure that they have a family member or friend to help with travel during this time period.
It may take some time before patients are able to see the final results of the surgery. They should expect to see some bruising and swelling for at least the first 2 to 3 weeks. 6 to 8 weeks after the procedure, they should be able to start seeing the full results of the cheek enhancement. However, it can take 2 to 3 months before the bruising and healing are fully settled. Once the incisions have healed, patients should begin to notice a fuller appearance in the cheek area. As the incisions are inside the mouth there are no outward scars. This helps to speed up the recovery time and improves the aesthetic results.
Risks & Complications
What are the main cheek enhancement risks & complications?
The surgeon will outline any risks and complications associated with the procedure. It is important to read up on these in order to make a fully informed decision regarding surgery. The risks to surgery include:
Tissue or skin necrosis
During surgery, some areas of skin may lose their blood supply causing them to die. This is known as necrosis and is much more likely to occur in smokers. Although it is rare, it is important as it can affect the final results of the surgery. In addition, patients may need another operation to correct these problems.
Cheek enhancement surgery can lead to damage or irritation of nerves near the cheeks. This may cause a temporary, or permanent, loss of sensation or movement in the face. Fortunately, this is a rare complication. Having a BAAPS/BAPRAS perform the surgery helps to minimise the risks.
Implant sizers and adequate preoperative planning help ensure the best possible cosmetic result. However, misplacement of the implants or fat can occur leading to asymmetry in the face. Asymmetry can be corrected through additional procedures.
Infection is a risk in any surgery. An infection will typically become apparent over the first two or three weeks when things are not settling down as expected. Mild infections (often wound infections or delayed wound healing) will settle down with antibiotics.
Signs of infection include:
- A temperature over 38° C
- Redness at the incision line that is beginning to spread away from the infection after the first 48 hours
- Yellow pus-like or foul-smelling fluid from the incision
- Increased pain or discomfort that is not relieved by your pain medication
Bruising & bleeding
Mild bruising and bleeding are common following cheek enhancement surgery. This is usually temporary. More severe bleeding may form a collection of blood under the skin, known as a haematoma. This may result in pain, bruising and neck or facial swelling. Haematomas typically occur within 24 hours of the procedure. These complications require medical attention, however, they should not affect your final result.
General surgical complications
There are common risks to any surgical procedure. Especially relevant complications include blood clots, risks of anaesthesia, nausea and vomiting and post-operative pain.
Choosing a highly qualified BAAPS/BAPRAS surgeon, preparing appropriately and following the aftercare instructions will decrease the chances of developing any of these cheek enhancement risks and complications.
Cheek Enhancement Surgery FAQs
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Cheek enhancement surgery adds volume to the face giving a fuller, more youthful appearance.