Beauty in Simplicity
The more simple the solution, the more excellent the outcome.
The appearance of your face is determined by three basic components: skin, soft tissues and underlying facial bones. Defined facial features, visible contours and natural angles that are proportionate all create structural balance in your face and a more attractive appearance.
If the structure of your face is disproportionate—the chin is recessed, the jaw undefined or cheeks are ﬂat—it can significantly affect your self image. If you are bothered by a small chin, weak jaw or lack of facial contour, plastic surgery with facial implants may benefit you.
A WEALTH OF INFORMATION
Understanding the Facial Implant Procedure
Facial implants bring balance and better proportion to the structural appearance of your face. They define your face by increasing projection and creating more distinct features. Facial implants are specially formed solid materials designed to enhance or build up the structure of your face, like your chin, cheeks, or jaw. The precise type of implants best suited for you requires an evaluation of your goals, the features you wish to correct and your surgeon’s judgment.
Chin implants can increase the size and projection of a chin that does not project in proportion with the forehead and mid-face. A small or recessed chin can also be described as one that seems to disappear into the neck of an individual of normal weight, rather than appearing as a distinct facial feature. Chin implants are specially formed solid materials designed to enhance or build up the chin.
Cheek implants increase the projection of the cheekbones. They add volume to areas which may be recessed or ﬂat.
Jaw implants increase the width of the lower third of your face. Much like the chin, a weak jaw is not well-defined and distinct from the neck, or slopes rather than angles from the ear to the chin. In some cases, both the chin and jaw can contribute to facial imbalance.
If symmetry among facial features is part of your goal, facial implants may be recommended to augment more than one facial region. It’s important to remember that all of our faces are asymmetric to some degree and your results may not be completely symmetric. The goal is to create balance and proportion. Your procedure may be performed alone, or as a complement to other facial contouring procedures such as nose or ear surgery.
Before You Decide…
Choosing Your Surgeon
There are several important factors to choosing a surgeon, including recommendations from friends, personality, physician training and board certification, and experience.
Referral from Friends: Many prospective patients find confidence if they have a close friend or other trusted individual who has already undergone a successful procedure. This is often a good first step in making a decision. However, not all patients know someone who has had surgery. Most of our patients are referred by satisfied friends who have been our patients.
Personality: It is important to develop a good relationship with a surgeon, where communication is easy and trust can be developed. A patient needs to feel intuitively that they are in good hands with someone they can trust. Bedside manner is important.
Training and Certification: In years past, only plastic surgeons performed cosmetic plastic surgery. However, in recent years doctors from many different specialties are more commonly performing cosmetic surgery procedures, including ear, nose, and throat doctors (also known as otolaryngologists and facial plastic surgeons), dermatologists, ophthalmologists, and gynecologists. Only a surgeon who has completed residency training in an accredited training program can become certified by the American Board of Plastic Surgery. There are many boards, and it is easy for patients to become confused or assume that when a doctor says they are “board certified,” it all means the same thing. BE CAREFUL!
Experience: Finally, consider the physician’s experience, the most important factor in making a decision. As with all professions, expertise is directly proportional to experience, meaning the total number of procedures performed. Medical literature illustrates that biggest predictor of success in surgery is volume, in other words, the number of times that a doctor has performed a procedure.
If the doctor is recommending a specific procedure, how many has he performed? How often does the surgeon perform this procedure?
While board certifications and training are important, a surgeon’s experience with the procedure itself is more important. Don’t hesitate to ask pointed questions about recommended procedures.
A good surgeon goes through a series of examinations and observations that are individual and dependent upon your specific situation and goals, but also factor in the surgeon’s expertise, training and experience.
The success and safety of your procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.
Be prepared to discuss:
- Why you want the surgery, your expectations and desired outcome
- Medical conditions, drug allergies and medical treatments
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
- Previous surgeries
We may also:
- Examine and measure your face
- Take digital photographs for computer imaging
- Discuss your options and recommend a course of treatment
- Discuss likely outcomes of facial implant surgery and any risks or potential complications
- Discuss the anesthesia options available
Questions to Ask
- Are you certified by the American Board of Plastic Surgery?
- Were you trained specifically in the field of plastic surgery?
- How many years of plastic surgery training have you had?
- Do you have hospital privileges to perform this procedure?
- Is the office-based surgical facility accredited by a nationally- or state recognized accrediting agency?
- How many procedures of this type have you performed?
- Am I a good candidate for this procedure?
- Where and how will you perform my procedure?
- What shape, size, surface texturing, incision site and placement site are recommended for me?
- How long of a recovery period can I expect, and what kind of help will I need during my recovery?
- What are the risks and complications associated with my procedure?
- How are complications handled?
- What are my options if I am dissatisfied with the cosmetic outcome of my facial implant surgery?
- Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me?
Who is a good candidate?
This procedure is a good option for you if:
- You are physically healthy
- You don’t smoke
- You have a positive outlook and specific goals in mind for improvement of facial contours
Because every case is unique, the only way to accurately determine which procedure is best for you is to consult with Dr. Alexander.
What does it cost?
- Surgeon’s fee
- Operating Room and Supplies
- Implant costs
- Anesthesia fees
- Prescriptions for medication
- Medical tests
Most health insurance plans will not cover facial implant surgery, related complications or another surgery to revise the appearance of your face. You must carefully review your health insurance policy.
To learn more about our partner in payment plans, please visit CareCredit.
Want to Talk to Dr. Alexander?
Because every case is unique, the only way to accurately give you advice is to consult with Dr. Alexander. Use this form to schedule a visit.
The Facial Implant Procedure
Preparing for the Procedure
- Take certain medications or adjust your current medications
- Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
- Stop smoking well in advance of surgery
During a preoperative appointment, usually 1-2 weeks before surgery, we will:
- Get lab testing or a medical evaluation
- Tell you what to do on the night before and morning of surgery
- Discuss the use of anesthesia during your procedure
- Explain post-operative care and follow-up, and what help you will need after the procedure
How We Do It: Tutorial
There are five basic steps to facial implant surgery.
Step 1 – Marking
Dr. Alexander will make careful marks on your face prior to beginning the procedure.
Step 2 – The incision
Incisions for facial implants are generally made inside the mouth through the mucosa that lies over the bone where the implant will be placed.
Step 3 – Creating the pocket
A space is created under the soft tissue of the face and over the bone.
Step 4 – Inserting the implant
The implant is placed into the pocket and positioned. No sutures are needed because the pocket is the precise size of the implant, so it cannot move or shift.
Step 5 – Closing the incisions
Internal absorbable sutures close the incisions inside the mouth. A light, compressive dressing is placed on the chin to decrease swelling.
Important facts about the safety and risks of facial implant surgery
The decision to have facial implant surgery is extremely personal and you’ll have to decide if the beneﬁts will achieve your goals and if the risks and potential complications are acceptable.
We will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications.
Some of the risks include:
- Unfavorable scarring
- Bleeding (hematoma)
- Poor wound healing
- Change in skin sensation
- Damage to deeper structures such as nerves, blood vessels, muscles, and lungs can occur and may be temporary or permanent
- Allergies to tape, suture materials and glues, blood products, topical preparations or injected agents
- Excessive scar tissue formation
- Firmness around the implant
- Shifting of implants and pressure on surrounding structures
- Skin contour irregularities
- Skin discoloration and swelling
- Skin sensitivity
- Pain, which may be persistent
- Possibility of revisional surgery
- Anesthesia risks
Important Terms to Know
Anesthesia—Local: The surgical area is numbed up with an injection, but the patient is awake. Sometimes a patient will be given an oral medication, like Valium, to help with relaxation.
Anesthesia— Sedation (Twilight): The patient is made sleepy with medications given through an IV. The level of sedation can be adjusted, from barely sleepy to very sleepy. Sometimes sedation is given by the surgeon, but most of the time it is administered by an M.D. anesthesiologist.
Biocompatible Materials: Synthetic or natural material used in facial implants and designed to function along with living tissue.
External Incisions: Surgical incisions made on the surface of your skin.
Intraoral Incisions: Surgical incisions made inside the mouth.
Be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.
When your procedure is finished, bandages will be applied to keep the surgical site clean and to support the position of the implant during initial healing. There may be an itchy feeling under bandages. It is essential that bandages remain intact and are not removed, for any reason.
You will be given specific instructions that include:
- how to care for the surgical site
- medications to apply or take orally to aid healing and reduce the potential for infection
- specific concerns to look for at the surgical site or in overall health
- when to return to the office
Following your doctor’s instructions regarding medications and other post-operative measures is key to a quick recovery. Herbal medications are available to reduce swelling, bruising, and to speed your recovery.
It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Avoid wearing any clothing that must go over your head.
In general our patients are very pleased with their facial implant surgery. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. Small revisions are occasionally necessary.