My comments are based on 20 plus years experience of performing Cheek Augmentation and having to remove cheek implants that were placed elsewhere. If you would like a more in depth evaluation, you can e-mail me photos of your face, front view not smiling if possible before the cheek implants were placed and now.
In patients under 40 years old that have 4mm or thinner implants for short periods of time, the tissues will typically go back as they were before the implants. The cheek bones should not be any smaller than they were before the implants were placed unless the plastic and cosmetic surgeon rasped then done for some reason during the cheek implant placement.
IMHO, you should give yourself a few months to see if the tissue sag improves. meanwhile, I’d recommend shaping the cheeks and filling in the NLF’s with Perlane. Nothing is 100% but I’d follow the above strategy long before agreeing to have any type of facelift now. If on the off chance that somehow you’re unusual and the tissues still sag, you may consider a
“Celebrity Lift” at that time. Hope this helps.

Dr Francis Palmer
What’s Your Number….the palmer code

When I have to remove Cheek Implants that were placed elsewhere, I will use Perlane to shape the cheeks. Restylane is too thin of a filler and Radiesse is too thick, IMHO. Perlane is placed in the fatty tissue layers, not in the capsule or on the bone as there’s no way to keep the injected Perlane in the proper place in those open spaces. Once the Cheek Implants are removed the shape, of the cheeks, will be basically the same as they were before the implants were put in. The thin capsule does not (this is an urban myth) contribute much to the overall size and shape of the cheeks. The Perlane typically lats 8-9 months. Obviously, there’s no magic in the Perlane and like cheek augmentation, with cheek implants, the aesthetic eye of the plastic and cosmetic surgeon injecting the Perlane is the key. Shaping the cheeks with Perlane takes about 10 minutes as an office treatment and patients can fly back home the same day.

1) Do you need to fill the newly empty capsule with the same amount volume as the implant or do you only need to use a fraction of the volume ( 1/5 or 1/4)? (I had my implant surgery almost nine years ago.)

2)Would you be able to target one area (middle, inner half) of the capsule or would the perlane naturally “re-inflate” the entire capsule? (I’m asking b/c my implants were placed too laterally, making my face wider, and I’d like to avoid adding volume back to the sides of my face if possible.)

3)I’ve read that perlane or restalyne can take a long time to dissolve when they are injected as a mass and also into a preexisting capsule. Is that true, and if so how long would it take to completely dissipate? (Six months? One year? Longer?) I’m so desperate to lose this artificial volume in my cheeks and the thought of still having it for an extended period of time after the removal is kind of frustrating.

Thanks for you

I’m glad to be of help. You are certainly not alone. I just got off the phone with a lovely lady from the UK who has a similar issue and just this week sent two patients back home that flew here for revision surgery. We offer phone consults where you and I can discuss the photos and plans to improve your appearance and then my staff will help yopu schedule your surgery if that is your wish. We have always had many out of country patients for over 20 years. The Celebrity Lift and exchange of cheek implants would take about 2 hours and you’d be able to fly back to Australia on the 8th post op day. If you e-mail jpeg photos, of your face front and side views, to drfpalmer1@aol.com my staff can schedule the phone consult and go from there.

Dr Francis Palmer

Photos would help in my evaluation but my suggestion would be a minimum incision facelift along with shaping, of the cheeks, using Perlane or an exchange of cheek implants. Don’t be so hard on yourself. We are frequently contacted by people, from all over the world, in similar situations. Using facial implants, IMHO, requires a quantum level increase in aesthetic judgement…something that’s not taught in any plastic and cosmetic surgery training and as such is not commonly understood. From this point forward, the correct aesthetic judgement should dictate what and how things are done to make you naturally beautiful.

Dr Francis Palmer