Facial Implants (Cheek and Chin)!
in the early evening of May 30th, 2006Cheek and Chin Implants require a keen aesthetic eye and experience with shaping the face. I saw a patient today that wanted a Chin Implant removed that was placed by another surgeon. From the pre-op pictures provided by the patient….I’m not sure he ever needed the Chin Implant in the first place.
I agreed to remove the Chin Implant. I don’t think that he’ll need anything but I told him that some Radiesse Injected to the Chin could be done after 1 month. By then the swelling from removing the Chin Implant will be gone and we’ll get a good sense of how his facial aesthetics play out.
You can’t place the Chin Implant under local (Novacaine) but it can be removed that way. Reason: placing the Chin, and Cheek, Implant requires lifting the cover of the bone..this is where the implant is placed. Lifting that tissue cover hurts too much for Novacaine but with an Implant removal, that space is already there. A small incision is placed within the existing scar under the chin and the tissues are dissected until the Chin Implant tissue capsule is found. A scalpel is used to open the capsule and the Chin Implant is gently dissected free and removed. Steri strops (reinforced trape) is applied over the area in order to encourage the tissue to shrink back down to the pre-implant size and shape. Viola!
If you are considering facial Implants like Chin or Cheek Implants, please take the time to read and learn my “Palmer Beauty Principles”…you can read more here: http://www.drfpalmer.com/palmer-beauty-principles.html
Most of all…be sure that you understand the aesthetics of facial beauty and what Facial Implants can and can not do to improve your own!
When it comes to Chin and Cheek Implants…like Rhinoplasty/Revision Rhinoplasty, there simply is no substitute for experience. Experience in using certain types of Chin and Cheek Implants over the past 16 years has given me a valueable working knowledge that can’t be obtained any other way.
For example, during my consultation with this patient…one of my staff interrupted me to ask questions on behalf of another patient (on the phone) who had a certain type of Cheek Implant material used for his Cheek Implants..he wanted to know if I had experience removing that particular kind of Cheek Implant. I have and they can be a real bear to get out as they have a tendency to adhere to the Cheek bone……I know because I have removed them before and that’s one of the reasons that I don’t use or recommend those Cheek Implants.
Have I ever not been able to remove a facial implant? Yes, for Chin Implant…only once on a female actress…it was an older type of Chin Implant that was made out a glass type material…it wouldn’t budge, even after Ihad dissected the tissue fromaround the implant. I tugged…and I tugged untilo the point that I was afraid the implant would break. The only thing that’s worse than a facial implant you don’t like…is a part of one that’s left behind….so, that must be avoided at all cost! I had warned the patient of that possibility before the surgery and I was doing other things, so she looked beautiful anyway when eveery thing was said and done.
Thankfully, I have always been able to remove and or remove and replace Cheek Implants but I just turned down a case the other day because of the particular set of circumstances, so I guess in a way…I won’t be removing that implant.
Let me leave you with a few parting comments and tid bits:
1. Facial Implants require a quantum level more sophisticated aesthetic judgement on the part of the Plastic and Cosmetic Surgeon…you are altering the facial architecture!
2. Facial implants according to my “Palmer Beauty Principles” must be different shapes for men and womens faces.
3. There must be over 60 shapes and sizes of facial implants (Chin and Cheeks)…I use only a handful…because aesthetically, I don’t like the other implants and what they do to the face.
4. Facial implants like Cheek and Chin Implants must be sutble….or you will look odd!
5. I don’t believe that Chin and Cheek Implants need to be sutured or screwed into the bone and in fact feel that this may cause dimpling of the implant…by the way, it also makes removal at a later date a real nightmare.
You can read more on Chin and Cheek Implants here: http://www.drfpalmer.com/CheekImplants.html
I’ll be writing more on Breast Augmentation, Facelifts, Botox, Restylane, Radiesse in upcoming weeks…as these remain very popular Plastic and cosmetic Surgery procedures here in Beverly Hills and elsewhere around the world.
Read more about Breast Augmentation here: http://www.drfpalmer.com/BreastAugmentation.html
Dr. Francis R Palmer, III
hi,
i recently removed a maxillary implant placed on the sides of my nose and I was wondering if I would look different in anyway. I read somewhere that removing a facial implant causes facial deformality and the scar tissue results in a face that looks like it has loose skin.
I am planning on replacing the implant in 6-12 months, after the original pocket closes. After I replace it, can I expect to have good results…considering all the scar tissue, etc?
Any information would be greatly appreciated.
thank you for your time.
ginji
ginji :: 1 month after
Hi Ginji,
Thanks for your post. I’m not sure of the type, size and placement of your particular facial implant. That makes it impossible for me to answer your specific questions. I suggest that you go back to the Plastic & Cosmetic Surgeon that placed the facial implant and ask him/her those questions. In general the amount of excess skin and tissue that remains after a facial (Cheek, Chin) implants is removed depends on:
1. The size of the facial implant…larger sizes have stretched the facial tissues more.
2. The length of time the Cheek, Chin etc. implant was in the face….a longer period of time means the tissue was most likely stretched to a greater degree.
3. The age of the patient. Younger patients tissues have a greater ability to shrink back down than older patients.
Removing an implant from the Cheek and Chin..or other areas of the face does not automatically mean that the face will be left deformed. the amount of scarring, in the skin, from placing and later removing the facial implant is obviously increased but the actual scar amount is highly variable from patient to patient.
What you didn’t say was why you had the implant placed in the first place….why you had it later removed and especially…why placing another implant is required. These are important issues that should be crystal clear in your mind before you have another implant surgery.
Hope that helps…
Dr. Francis Palmer
drfpalmer :: 1 month after
Dr. Francis Palmer,
Thank you for the information. Originally, I had the implant placed to fill in the depressions near my nose. I always felt that it wasn’t placed exactly where it should be because one side always felt uncomfortable. So, 2 years later, I decided to have it removed. I do want to put it back because I do not like having deep lines by my nose. I know that there are other alternatives, such as radiance, etc. But, I am only 26 years old and I do not want to go back for radiance every 6-12 months. An implant seems better, in view of costs and being more permanent.
However, I am afraid of having disappointing results w/the placing the implant once again. Another plastic surgeon told me that the outcome of second surgerys, particularly dealing w/facial implants, are never as good/nice as the first surgery because of scar tissue, etc? My plastic surgeon disagrees, he said it depends.
I am wondering if there is a “high” chance that the implant may shift back into the original pocket? Will the orignal pocket completely close…how long would u recommend I wait until reinserting the implant?
Is it true that the outcome of secondary implant facial surgeries are not as nice as the first?
Thank you so much for your feedback and time.
Ginji
ginji :: 1 month after
Hi Dr. Palmer,
I am 30 years old and I had large cheek implants put in May, 1999 (approx 7 years ago). I asked for cheek implants because my cheekbones were flat and I wanted more definition. I am interested in having these removed for 2 reasons: (1) I am concerned about bone erosion caused by the implant, and (2) as I have gotten older, my face has thinned out and I fear that my face will only get thinner as I get older and the implants will look odd. I am concerned about the risks/complications associated with the removal of the implants and I was hoping that you might be able to provide additional info.
Thank you in advance for your time.
Sincerely,
Valerie
Valerie :: 5 months after
Hey Valerie,
Bone erosion is pretty rare in cheek implants, so I’m not sure that’s something you need to be concerned about. The loss of facial fat, as one ages, however is a very real thing and it may make the cheeks look too large for your face. I suggest that you see a competent plastic and cosmetic surgeon that does a great deal of cheek implants…and go for evaluation and consultation.
We exchange cheeks implants all the time…typically because the patients have had their cheek implants done elsewhere and don’t like the size, shape or positioning. I like using silastic cheek implants that are very easy to remove.
Dr. Francis R Palmer, III
drfpalmer :: 5 months, 1 week after
I had radiesse injection to my cheeks. It looks good in repose and pretty, but I think it made my face look much fatter when I smile and my smiling looks stiff on my upper lip. I had it done almost 3 weeks ago. I am thinking maybe that is because it is new, hard, and swollen right now and may soften up as time goes on? I really like it otherwise, and I wish it was permanent if it softens up. I also wonder if I had silicone cheek implants (small ones) would it feel hard and look fat when smiling also? I notice some of the movie stars have that look. I did take a chance because the lady who did it does do many cheeks, but she did a good job I think (and which is why I opted for a filler).
Christy :: 5 months, 1 week after
P.S. By stiffness I mean that the upper lip does not rise up as much to show my upper teeth. It hangs much much lower after the radiesse injections. I hope this resolves.
Christy :: 5 months, 1 week after
Hey Christy,
It depends on how much and where the Radiesse was placed. Cheek Implants are permanent and yes, they may also give a temporary sensation of preventing raising the upper lip. You may consider a consultation with an experienced Plastic and Cosmetic Surgeon to discuss these options.
Dr. Francis R Palmer III
drfpalmer :: 5 months, 2 weeks after
Yes Christy…I understand what you are describing.
Dr. Francis R Palmer, III
drfpalmer :: 5 months, 2 weeks after
Hey Dr. Palmer…i notice my smile coming back today. It feels nice now. It did take almost over a month ! Not bad stuff (radiesse) at all.
Christy :: 5 months, 3 weeks after
Hi Dr. Palmer:
I had Radiesse injected into my chin yesterday (non-surgical chin enhancement) and I don’t know that I like the result. I had a couple of questions: 1) I spoke with my doctor’s office today regarding whether something can be injected to dissolve the Radiesse. My doctor’s office said that yes, there was something that can be injected to dissolve the Radiesse (should take a couple of days). I have researched crazily and have not found anything that promises to do this. Do you know if such a thing exists and what the side effects/consequences are of doing it? My 2nd question is: how long (in your experience) does the Radiesse last in chin augmentations? I’ve read that it can last anywhere from 1-5 years, but I was wondering what your experience was with it.
Thank you in advance!
Sincerely,
Valerie
Valerie :: 7 months after
Hi Dr palmer
I had cheek implants about 10 years ago and ever since i have been able to move them up and down a little the back part of the implants are pretty fixed. I havent had any problem but is this okay. Thanks
Chas :: 7 months, 4 weeks after
Well, you shouldn’t be able to move the implants. This doesn’t mean you have a problem or that you need to exchange them but this isn’t normal either. You might want to have a consultation with a plastic and cosmetic surgeon experienced with cheek implant augmentation.
Reasons to exchange/remove cheek implants.
1. you want a different size or shaped cheeks
2. the implant(s) have dramatically shifted position on your face. Beware of manipulating them…you maymake them further dislodged.
3. evidence of infection. Cheeks become red, tender and enlarged. Another reason not to touch and move them around.
Dr. Francis R Palmer III
drfpalmer :: 7 months, 4 weeks after
Hi Dr. Palmer,
I had a chin implant 20 years ago (in 1988) by a well-known Beverly Hills surgeon who is now retired. I have never been happy with the implant. I am now considering having it removed. I believe it was a silicone button?
Before doing so, I would like to know what my chin will look like after removal. Will it look like it was before (except for normal aging). I would like to have my natural chin back.
Thank you.
Dina
Allie :: 8 months after
Hi Dina,
I am familiar with the old silicone button chin implants. The look that they gave the chins were never my favorite and I rarely used them but I have removed them numerous times. Once the button implant is removed your chin tissues will not have support unless you place another, more aesthetically correct chin implant back in.
Now, depending on the size of your current implant, the amount of excess chin tissue will vary. If you’re not going to put in anotehr chin implant, you may need a chin tuck which is typically performed at the time the chin implant is removed. The incsion is the same one used to remove the chin implant…I use one hidden under the chin.
I do not advise having an incision for chin implant placement or removal inside the mouth as this can increase the risk of infection and cause permanent damage to the mentalis muscle attachments causing a droopy chin to occur at a later time.
A simple examation of your chin will most likely provide the answers. Would help if you had an idea of how thick the button implant is and just so you know…spme of the older button implants actually have a silicone gel that can be damaged at removal…
Dr. Francis Palmer
drfpalmer :: 8 months after
Hi Dr Palmer
I wrote about the cheek implants I had 10 years ago can I remove these without any problems will my face go back to original state i am 36 now the implants are not very big. Also I dont know if you want to comment on another doctor they were done by Dr Leslie Stevens.
Thank You
Chas :: 8 months after
Hi Dr. Palmer,
I had a medium (female) silicone rubber chin implant placed about three and a half months ago from a popular Beverly Hills surgeon. I am going to be removing it in the next three months from the same surgeon because I am not happy with it. I am 19 years old, which means young skin. I am hoping for my chin to look the same as before, but I am a bit worried. Do you think there will be deformities, or is it unlikely? My surgeon told me there will not, and that my skin will snap back to place. Any information to give me in regards to this will be much appreciated. Thank you so much.
Ciscandra :: 8 months, 2 weeks after
Hi Ciscandra,
First, may I please say that there are no male and female implants only various sizes and thicknesses that the plastic and cosmetic surgeon must make the judgement of what would be appropriate for use on a woman versus a man. Sorry, had to get that off my chest…now to your question.
In 4 months, it’s unlikely at your age that any significant stretching of your skin has been caused by the chin implant…but it’s not impossible. Any reason it’s not coming out sooner? Less time to stretch the skin. You should talk about this with the Plastic Surgeon that did the Chin Implant. I typically tape the chin up well after the implant is removed. You didn’t mention replacing the implant and it sounds like you’re looking for your pre-surgery chin back..is that correct? If so, you should get it barring any unforseen problems…but ask the surgeon who put the implant in to be certain.
I have had to tuck the excess skin under the chin when large implants are removed.
Dr. Francis R Palmer, III
drfpalmer :: 8 months, 2 weeks after
I had a chin implant 8 weeks ago. Its too far left,w/arm under jaw line. How soon is it safe to fix it?
Jodie :: 8 months, 3 weeks after
Hi Jodie,
Off hand, I’d say 3 months, so you have 4 weeks left. By that time, the initial swelling should be gone and you would be able to get a good idea of where the ends of the Chin Implant are located. Be sure, it needs to be repositioned…by seeing the Plastic and Cosmetic Surgeon who performed the Chin Augmentation.
Dr. Francis R Palmer, III
drfpalmer :: 8 months, 3 weeks after
Dr. Palmer,
I have been worried all day because I went to the dentist yesterday and received an anesthetic shot right next to my right nostril…in the area where my maxillary implant is. I have been worried that it is leaking as a result. I have been feeling both sides and seems like the right side is now smaller than the one on the left.
What should I do? In the case that it did break, is it considered an emergency? And lastly, are there big complications in explanting such an implant?
Thank you,
Debby
Debby :: 9 months after
p.s.- it was a silicone implant.
Debby :: 9 months after
Hey Debby,
Although I can’t give you specific advice regarding your Malar Augmentation (Cheek Implants), I can tell you that Silastic or Silicone Cheek Implants are solid and do not have any gel or liquid to leak. Please contact the Plastic and Cosmetic Surgeon that performed the Cheek Augmentation to be certain…but it’s unlikely that the needle damaged your silastic Cheek Implant.
Dr. Francis R Palmer, III
drfpalmer :: 9 months after
Dear Dr. Palmer,
I’m an oral surgeon that has practiced for 35 years. I had a question in regard to the chin implants.
In regard to your recommendation of extraoral incisions, I’ve entirely removed the attachments of the mentalis muscle several times in order to perform grafts and never had the problem of having a droopy chin afterwards. I’m not very familiar with facial implants, but I would like to know what is the reason why they provoke resorption of the underlying bone. Is it the pressure they make that provokes the resorption? What kind of implants don’t cause resorption?
Thank you very much for your attention.
Sincerely,
Dr. Felix Pelcman
Dr. Felix Pelcman :: 9 months, 1 week after
Hey Doc,
Let’s see if I can’t give you some answers.
1. The droopy chin can result from removing, cutting the Mentalis Muscle attachments and the external incision heals so well…I’m not sure why anyone would do the external incision for Chin Augmentation.
2. I would guess that it’s a combination of pressure caused by the Chin Implant on the bone as well as persistent motion of the Chin Implant caused by the overlying muscles that causes bone erosion in some patients.
3. I think all Chin Implants could potentially cause bone erosion…harder materials would seem more likely to erode bone than softer materials. I like Silastic Chin Implants for the many reasons stated on this blog.
Good Luck. Hope this helps.
Dr. Francis R Palmer, III
drfpalmer :: 9 months, 1 week after
Hi Dr. Palmer!
I had a chin implant 8 days ago. I want to remove it (with no replacement) now for several reasons:
1. I didn’t do enough research and didn’t realize that bone erosion was a possiblity. I got the implant without any screws and I read that the chances of bone erosion is higher for ones done w/o screws. I specifically don’t want screws bc I read about potential calcification.
2. My lower teeth are hurting the last few days and shifting - I didn’t know if it’s related to this, but it never hurt before. I can see that the implant is really close to my tooth bone.
Basically if I had done more research before the operation, I wouldn’t have opted to do it. I did ask my surgeon what are all the risks but bone erosion was never mentioned.
My question is:
If I leave the implant in a little longer and the capsular tissue forms, then remove it, will I have ‘more’ of a chin after I remove it? (my PS told me that it happened to one of his patients who had it inserted and removed over 3x due to infections)
A. If so, how long will I need to keep the implant in for?
B. If not, and I remove the implant imediately, (say within 16 days after the implant insertion) will I look like before the surgery within a few weeks? (any hence loose skin etc…
Other info:
Implant material used: Silastic
Size - medium, minimal wings
Incision area - through the mouth
Other - I also had a neck lipo done with the chin implant
Many Thanks!!
Chloe
Chloe :: 10 months after
Sorry few other things, the lipo was done through under the chin and behind the ears. Other reason for removal includes my mental state not really ready for this change (changing my look, loosing myself etc..). I had a bleph a year back and loved it. It began a mini obession with plastic surgery, but never really doing anything else until now - the chin aug & lipo.
Thank you for reading this and any insight on your part is greatly appreciated!
Chloe
Chloe :: 10 months after
sorry forgot, I’m 29 yrs old.
Chloe =)
Chloe :: 10 months after
Hi Chloe,
It sounds like you are having buyers remorse about your chin implant…but 8 days after the surgery is typically not a good tiome to make major decisions about your Plastic and Cosmetic Surgery Procedure.
I advise you to speak with a trusted fien or family member and really give this some thought. If you are unwilling to accept even the slightest possibility of bone erosion, you may decide to take out the implant but that does not always occur and I frequently use chin implants in my beverly hills practice.
Aches and pains after surgery are normal. You have to give it a few months before evrything is healed. How do you like the look of your chin so far?
Continue speaking with the plastic surgeon that performed the chin augmentation….take a deep breath and relax. No matter what your decision, if it’s made in the next couple of months chances are your skin will shrink back down and you’ll look like you did pre-op….no, the scarring or capsule will not augment your chin to any noticeable degree.
Dr. Francis R Palmer, III
drfpalmer :: 10 months, 1 week after
hi dr. palmer i am from INDIA.my name is shilpi .i look very simple girl people say i look good . my prob is tht i wan to have high cheekbones i mean very high beautiful round cheekbones..i have a round face .i m just 19 yrs old..so can suggest some good cheek implants iwanna get my implants done by u only for which i’l be coming to ur country soon ..plz help i want to look pretty & beautiful .
shilpi :: 10 months, 2 weeks after
Hi Dr.Palmer,
I had posted a message a while ago which you replied to. I am having my rubber silicone implant removed may 17. In May it will be the 6th month post-op. I found the size of my implant…so i figured you would have better judgment with this information. It gave me a 7mm projection. my doctor classified this as “medium” and that “there will be no sagging or dimpling due to my young skin.” I am 19. What are your feelings in regards to this? The implant seems to be in the shape of a half moon, curving around the chin, only extending a bit into my jawline.
Ciscandra :: 10 months, 2 weeks after
I actually just found out it was an extended anatomical chin implant, 5mm in projection, and rubber silicone. Btw, it was not a terino extended anatomical chin implant which seems to be more square. On implantech.com it gives a full description.
Ciscandra :: 10 months, 3 weeks after
Hey doctor palmer,
i am writing because it has been 8days since my surgery to my chin and im really freaked out about it. I have talked to my mom and my boyfriend and they both think the chin implant projects out too far. I really want to get it removed because i am feeling so depressed right now with how i look. I was wondering if this is normal? I was also wondering if i do get my chin impant removed, how soon can it be done? Or if it is normal, how soon until the swelling will go down? I feel like i have a man-chin right now..and i am a 22 year old girl with a very delicate face besides the implant. please help. I am sooooo miserable and scared.
DJ :: 1 year after
Hey DJ,
OK…first take a deep breath and relax. It’s not unusual to have some swelling after a chin Augmentation with implant that makes the chin appear too large. You should know the size of the chin implant that was used. #1, 2, 3 or 4. Sometimes they are labeled small, medium, large and extra large. If you have a small chin implant (#1), most likely what you see is swelling. Ask your Plastic Surgeon what size was used and voice your concerns. He/she may just tell you that most of what you see right now will go down.
If your chin implant is a silastic (silicone) implant it is typically quite easy to remove and can be done at anytime…..but most plastic surgeons would tell you to try and tough it out for at least 1 month to be sure that you don’t like the result and are asure that you want the implant removed. Hope this helps.
Dr. Francis R Palmer, III
drfpalmer :: 1 year after
thank you so much for responding, i am starting to feel a little better about it, getting used to it a little and whatnot…but i also had one cheek implant repositioned because it fell, and now i am thinking that my unsatisfaction with my chin really has to do with my cheek because on one side i like it and on the other side my cheek looks huge…i can tell its too low, again..and when i asked my doctor about it he said he put a larger size in and that that was the problem all along…i disagree, its in my body and i can feel that its off, i also dont understand why he wouldve put in a bigger one from the side that looks right! is this a normal practice? im very frustrated that this is still the case a second time around …honestly, i am feeling around in my cheek and it almost feels like there are two implants in there…like he never removed the first one…i know i probably sound a little crazy right now because i first said my chin, and now i am saying my cheek, but i think its because i didnt fully understand what was off with my face. I had my surgery on june 7 and its the 20th today. should it still be rediculously big? i can send you a photo if you like so you can get a view of it. thank you for taking time to write me back.
ps. the chin implant was a 2 (my doctor said it was like the smallest one, but with wings)
the cheek implant he put in was also a 2, but the one on the other side is a 1.
DJ :: 1 year after
ps. they are both sillacone
DJ :: 1 year after
pps. is it just as easy to remove a cheek implant? like could i remove it sooner than later? i talked to my doctor about this and i felt as though he was treating me like i was acting so silly…
DJ :: 1 year after
Hey DJ,
I’m not sure that I answered this so forgive me if I’m repeating myself. Silicone Implants are very easilly removed but be sure that you’ve waited 3-6 monthjs to allow the swelling and the tissues to heal before another operation.
Yes, we do evaluate photos and offer phone consults. Ypu can e-mail my staff for further info at drfpalmer1@aol.com.
Dr. Francis R Palmer, III
drfpalmer :: 1 year after
There was a question about Artecol in the corners of the mouth and cheeks that I can’t seem to find. Here’s my reply. Kenalog (cortisone) is an anti-inflammatory steroid that is sometimes used to dissolve things in tissues of the body like scar tissue and yes some fillers like Radiesse. I am not sure that kenalog injections will dissolve the Artecol. You should ask the plastic surgeon that injected the sartecol and yes the kenalog is injected directly into the area that you’re trying to dissolve. The kenalog can also dissolve your own fatty tissue leading to depressions and deformmity, so it’s not something that should be taken lightly.
Dr. Francis R Palmer, III
drfpalmer :: 1 year after
Hey Dr Palmer,
I am a 21 year old girl.
I just got a chin implant 17 days ago -
1. is that too soon to see the basic look of what it will be like? I feel like it is making my face look extremely long. Also, is it normal for the face to look longer with chin implants? I thought it was supposed to be the other way around
2. My other problem with it is that i have a muscle in the center of my chin that kind of like a button shape - when i didnt have the chin implant it would poke out only when i smiled, now that its sitting on top of the implant i feel that it is making my chin look too prominant…Will this eventually go down with the swelling? or is the swelling basically gone by now for the projection of the tip of my chin?
Im trying to decide if i should take it out soon so that my skin wont stretch.
Oh, my doctor used a size medium sillacone implant
Nita :: 1 year after
Hello Dr. Palmer, i just recently had a rhinoplasty and chin implant done. I am 4 days post op and i do not like my chin implant at all. I believe he used a # 2 anatomical silicone implant with wings, and the wings just doesn’t seem to go with my profile at all because i have a weak jaw also. so it seems as if it is popping out. I know it is pretty early to be freaking out about it, but the more i think of it, even after it heals, it will still not look natural with my face because of the protruding feeling of the wings. Also my head is not all that symmetrical so that makes it even more obvious for me. Please tell me if this is normal and if i should wait it out, or should i already talk to my doctor about taking it out and maybe jut replacing it with an implant that does not have “wings” . i might be a little more happier with that. Thanks
Mark :: 1 year after
oh yeah, he said he was using a “small # 2″ at the pre-op appointment. i asked him earlier when the swelling would subside and he said in a week or so but i have yet to bring up the part the bothers me.
Mark :: 1 year after
Hey Mark,
Chin Augmentation can take a month or longer for the swelling to subside. I advise patients to wait at least a couple of months or more to be sure thet the chin is fully healed before making any judgements about whether they like the aesthetic result or not. The implant is very easy to remove as long as it’s silicone if you ultimately decide that it’s just not working for you. Bring this up the next time you see the plastic surgery who performed the surgery and discuss your concerns with him or her.
Dr. Francis R Palmer, III
drfpalmer :: 1 year after
Hey Mark,
I should also mention that the smile and sensation of the lip and skin over the chin can all be disrupted for months after the chin augmentation. Typically this all resolves within 6 months after the surgery.
Dr. Francis R Palmer, III
drfpalmer :: 1 year after
I have a 10 year old chin implant that has sides to it.
One side never appropriately fixed to the bone. Now it sticks out and looks strange. Also, when I laugh I also look strange (getting worse with age). I also have fairly large cheek implants.
What can I do now???
tricia :: 1 year, 1 month after
dear Dr. palmer,
i had submalar implants put in exactly 6 days ago and i don’t like it at all. it looks really awkward. i dont know if it’s because of the swelling or not but im thinking of removing it..i just wanted to ask.. i heard it is fairly easy to remove cheek implants if it is silicone, but mine was a coral porous material..will it be hard to take out? and another thing i wanted to ask was.. can i remove these implants with local anesthesia and not general anesthesia?
ann :: 1 year, 2 months after
Dear Dr. palmer,
it’s the same person again.. i found out that those implants arent submalar implants but implants to fill in the depressions around the nose.. my questions from the previous posts still remain. I don’t like to go under general anesthesia because i just have worries about it..and i was wondering one more thing.. i have difficulty smiling and when i smile my upper teeth barely shows. it has been a week since getting the implants.. will these things fade away like the radiesse injections mentioned above? or are these things abnormal with implants.. it has been a week of my surgery.
P>S please Dr. palmer..i am anxious and worried..please reply back when you can
ann :: 1 year, 2 months after
Hey Ann,
Yes it is possible to remove silicone implants from the cheeks under local anesthesia however, since AI don’t know about these coral implants…I’m not sure. You may want to contact the plastic surgeon who did the cheek augmentation and ask that question. Your post op swelling is obviously not subsided yet and be sure to factor that into your decision.
Dr. Palmer
drfpalmer :: 1 year, 2 months after
Dr. Palmer,
Do you have anyone that you would recommend in the Atlanta area?
tricia :: 1 year, 2 months after
Sorry, I have no idea.
Dr. Francis Palmer
drfpalmer :: 1 year, 2 months after
hai doctor…
im planing to do chin and cheek implants..
im planing to make my cheeks slim and my chin more sharp and nice.but rite now im wearing braces..so can i do the surgery??will there be any side affects??is it after i did this surgery i need to stop cheecking the dentist??
please tell me??
lia :: 1 year, 2 months after
Hey,
I’m 19 years old and had a chin implant put in a little over a year ago and I am still not happy with it. I feel that it has made my chin too wide from the front, although I really like the changes it has made to my profile. Though I’m not completely sure the type of implant is, I think it is a silicone implant and my doctor told me that it went up into my jaw bone as well- so I am assuming it is an extended anatomical implant. I’m interested in getting it replaced with an implant without the wings on the side. I have a few questions though:
Will this allow me to get my old jawline back while keeping the added projection from the side? (although I know it won’t be exactly the same, I just hope it will be thinner like it was before).
What are the complications that result from this surgery?
If my doctor put the implant in from under my chin, what is the risk of drooping/sagging with replacing it the same way?
How long will it take for this to heal- will it take longer than the first implant to heal?
Thanks so much for your time.
-Chloe
Chloe :: 1 year, 2 months after
Hey Chloe,
Be careful about chin implants that do not have the tapering sides, you call them wings, as these tend to make the chin look elongated like a Pharoh’s chin…not a good look. Another option is a smaller, more rounded anatomical implant version.
Revision Chin Augmentation is quite easy and the recovery time is quicker than the primary chin augmentation because the tissue plains have already been elevated. Sounds like you need a consultation with a plastic and cosmetic surgeon about the issue. Hope this helps.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 2 months after
Hey Lia,
I would have no problem doing those surgeries with your braces on if you were my patient but I guess it will depend on the plastic and cosmetic surgeon that you choose to perform your procedures…they may or may not agree with me.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 2 months after
hai doctor..
i would like to ask another question to u…
after i did my chin and cheek implant can i still continue see the dentist to change my braces???
this is due to i need to change it every 1 month..
so can i do it after i did the surgery???
is there will be any side effects???
thank you..
lia :: 1 year, 2 months after
Dear Doctor,
i had cheek implants put in 7 months ago. they were silicone and fixed with sutures. one is too close to my eye and i want to move it. is there a way of doing this without surgery. i was told contiual massage could make it shift
thanks
toby :: 1 year, 3 months after
Hey Toby,
Typically the Cheek Implants are stable in their position after 1 month. I trim the raised flange on the Cheek Implants during placement to avoid it being felt and/or seen along the lower eyelid. I don’t believe that there’s a way to make the Cheek Implant move down away from your eye socket at this late date without surgery (locally trim down that area or completely re-position the entire cheek implant)but you’ll have to ask the plastic surgeon who did your Cheek Augmentation that question.
Cheek Implants don’t move much when I put them in for almost 20 years now performing this procedure quite often….I don’t use internal fixation methods nor do I use external sutures (these have to be removed after 1 week) and the Cheek Implants are not stable in position for about 1 month…so the external sutures really aren’t around long enough to be of much use. I do have all of my Cheek and Chin Augmentation patients use a U-shaped pillow to sleep on for the forst month. This avoids sleeping on your chin or cheeks that will potentially move the implants after surgery.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 3 months after
Dear doctor Palmer,
First off: thank you for this great site and for all the useful information you post on it.
I got a chin implant 2 years ago. Since it gave too much inferior projection and was far too wide in the midlateral zone, I had it removed 2 weeks ago. I’m scheduled to get a new implant in 4 weeks. I have two questions I hope you may be able to answer:
1. When I asked my plastic surgeon for high central -instead of submental- augmentation, he suggested a chin implant with no/small tapered sides, since I don’t need midlateral augmentation. You told Chloe on this page to be careful with chin implants without tapered sides. Would the ‘anatomical chin implant’ from Implantech be a good compromise?
2. Although less than last week, I can still feel there’s some fluid in the pocket. Will 4 weeks be enough time for the periost to reattach to the bone? I’m kinda worried my new implant will move into the old pocket. I should note my plastic surgeon only used some steristrips over the wound, and didn’t use any other dressing to force the pocket to disappear.
Thanks in advance for your time and knowledge
Cornelis :: 1 year, 4 months after
Cornelis,
In my opinion chin implants that don’t taper at the sides elongate the chin in an abnormal fashion giving the patient a Pharoh’s Chin….an anatomical implant is more aesthetically correct again in my opinion.
4 weeks is not enough time for the tissues to re-adhere…your suspicions are correct. I would think more on the order of 4-6 months.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 4 months after
Dear Dr. Palmer,
thank you so much for your advice.
Cornelis :: 1 year, 4 months after
You are very welcome…spread the word.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 4 months after
Hi Dr. Palmer,
I just came across this site. Thank you so much for it. I had rhinoplasty at the age of 19 (I’m now 35) the Dr. who performed the surgery strongly suggested cheek implants and I was too timid at the time to say no. I do know that he made a small incision near my sideburns on each side but i don’t know what type of material he used. I’ve gone to a couple of docs to have them removed (I hate them, the implants not the docs, lol ) and all have said no. I had revision rhino by a prominant BH plastic surgeon 3 years ago and even he wouldn’t remove them. Can you help? Thanks
Bobby :: 1 year, 4 months after
Bobby,
Is the doctor still around who placed the cheek implants. If so, call the office and see what material the cheek implants are made of…this is very important. If the implants are silastic, they should be able to be removed. I’m curious why 3 plastic surgeons have told you they couldn’t or wouldn’t remove them. What did the plastic surgeons give as their reason?
You can always come for a consultation and yes, I remove many cheek and chin implants that patients don’t like for various reasons that were placed by other plastic surgeons….I believ that this is just an aesthetic difference in opinion. You can e-mail us pictures of your face front, profile and 3/4 view as jpegs to drfpalmer1@aol.com or call to schedule your consult 310-652-9583.
If you can’t determine the material of the cheek implants, I’ll have to order a facial CT scan to try and determine the composition of the implants. Medpore and the older glass implants can’t be removed, so let’s pray they’re not that type of cheek implant.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 4 months after
Dr. Palmer,
Thanks for getting back to me so quickly, that shows a lot of integrity. The plastic surgeon who performed my surgery was named Julius Newman and he was already ancient 15 years ago so I’m assuming he’s passed away by now. I wouldn’t even know who to contact.
I’m guessing that the other plastic surgeons were wary of possible damage to facial muscles or nerve damage if something went wrong and that’s why they didn’t want to remove them. Just a hunch.
I’m no longer living in SoCal but I do visit family so I’ll make an appointment next time I’m out there. Again, thanks.
Bobby :: 1 year, 4 months after
You’re welcome.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 4 months after
Hi Dr Palmer,
I am a 37 year old man, I have had jaw implants in the past (5 years ago) to widen my lower face, I recently had a chin implant done and it seemed to elongate my face, are there chin implants that can widen instead of elongate the face but still give a man a square musculine chin? Also I have seen a few Plastic Surgeons and most seem to agree that I am lacking in the cheek area. I am absolutely terrified of cheek implants for men because I an afraid of looking odd and/or feminine but most importantly of looking “made up” I had a male friend of mine that had cheek implants and some of my other friends nicknamed him Madame (the puppet on the Hollywood squares from the 80’s) Sad that people can be so cruel. I was wondering how your selection of cheek implants differs and what you do to avoid the “puppet” look. Can a facelift or midface lift be used to elevate the cheek pad and make it look more pleasing? Last question, does a facelift tighten and restore facial contour or is it something reserved for older loose skin? Thank you in advance for your reply!
Mark
Mark :: 1 year, 4 months after
Hey Mark,
Chin implants work great and I have had no issues with them for 20 years. The same with cheek implants. As I have stated in this blog many times…there is no magic in the implants themselves but in the aesthetic eye and surgical skill/experience of the plastic and cosmetic surgeon using them.
You should be able to get a nice aesthetic improvement using the proper size and shaped chin implant. The same with the cheeks. Now, the poor friend who looked odd must of had an improper size and shaped set of cheek implants. A smaller, more narrow and subtle pair would have been more aesthetically pleasing. You may want to visit my website and read more about cheek and chin augmentation.
http://www.drfpalmer.com/CheekImplants.html
Facelifts do not restore facial contour but remove excess skin and tighten the underlying SMAS layer. Facial contour, which is at the facial bone level, exists or it does not. If it doesn’t, removing skin gives the windswept, operated look unless facial contour is re-established using implants or Radiesse injections. Again, aesthetic judgement is key. The cheek pad is fat, which does not respond well to sutures that tend to just pull through. Take a look at my “Celebrity Lift”. http://www.drfpalmer.com/PalmerCelebrityLift.html
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 4 months after
Dear Dr. Palmer,
I had chin implant placed 20 months ago. I felt it was out of place. My surgeon revealed that he’d put it above the periosteum. It migrated. 6 months later, he charged me $$$ again to open up the pocket and place a suture into the muscle to “anchor” it. The implant is now migrated to just below the vermelion border of my lower lip. Is it common practice to place the implant above the periosteum? Everything I’ve read says to place it sub-periosteally. I now have chronic jaw discomfort. Thanks
Nikki L :: 1 year, 4 months after
Hey Nikki,
Yes, there are some plastic and cosmetic surgeons that place chin implants above the periosteum. I believe that most plastic surgeons however feel it’s better to use the sub-periosteal approach and I have done so for over 20 years. It really doesn’t matter what was done previously as the chin implant has moved and may erode into your mouth if nothong is done.
You didn’t mention how the original chin implant was placed…from an incision under the chin (my preferred method) or through an intra-oral approach. The intra-oral approach, in my opinion, has multiple disadvantages including possible upward migration of the implant to the mental sulcus.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 4 months after
Dear Dr. Palmer,
Thank you for your rapid response. You are very generous to donate your time to patients on this message board. My surgeon chose to use the intraoral technique both times to avoid external scars. I spoke with him today and he suggested we go back a 3rd time and open up the pocket and “put many more sutures in to secure it.” He said that the probable reason for the implant migration was because of the shape of my chin. I said “No, sutures didn’t work last time. I think this particular implant needs to come out.” Dr. Palmer, do you suggest I have him take it out and let my face heal a few months before attempting re-insertion? Or do you suggest I have hime replace the implant (smaller?) in one procedure. I am the main breadwinner in my family and I can’t afford to keep taking time off for this elective surgery and all the attempted revisions. At the same time, I want this to be done right so I can have some resolution to this chin implant issue. My doctor has very good credentials and I want to trust him but I’m afraid of being disappointed again.
Nikki L :: 1 year, 4 months after
Nikki,
That’s the million dollar question…trying to predict the future. If you’re trying to hedge your bets, you might consider taking out the chin implant through a small incision under your chin under local anesthesia. This will have just a few days recovery and you should be able to resume work at that time but avoid strenuous activity for 2 weeks. let the area heal for 6 months and then replace another implant through the same incision under the chin. Just my opinion.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 4 months after
Hello Doctor, I have several questions for you and may be calling on your expertise to correct these issues.
1. I had chin and cheek implants 2.5 weeks ago, I feel there is some asymmetry going on with the cheek implants.
The left cheek implant side seems to protrude outward much more then right side,and you can see the implant it seems.
On the right side you can barley tell I have an implant, is the left side just very swollen? have you run into this before? is this the way it’s going to stay?
2. On the chin implant the wing on the right side seems to have turned downward some how? I can clearly feel it, almost like it snagged up on something and turned downward, have you seen this before? is it correctable?
3. How long does it take for numbness to go away on the corners of my upper lip? also numb on the left side of my chin.
thank you so much, your words will stop my mind from racing, and get on the path to correct these issues with the right P.S
Jesse :: 1 year, 5 months after
Not sure if you would want to know this but the cheek and chin implants were done through incisions in my mouth, hence the numbness…
Jesse :: 1 year, 5 months after
Hey Jesse,
First, the numbness. This typically resolves within the first several months, slowly. If you feel a section of the implant below the rest, this may be the way the Chin Implant was placed. If you think you feel the edge of one of the Cheek Implants, again this may be the way the Cheek Implant was placed. Did the Plastic Surgeon use the same thickness cheek implant on both sides? It’s not unusual for one cheek to be more swollen than the other. Has your plastic surgeon recommended icing your face after the chin and cheek augmentation? If not, perhaps you could call the office and ask for their specific instructions on reducing the post op swelling. All that being said, you should give your face a month or two for most of the swelling to subside before making any decisions.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 5 months after
Thank you so much for your quick reply!!! I should have explained that I showed my PS the chin implant and cheek implants before posting this, he said he beleives the chin implant moved, and the wing on the right side should be going upwards to sideways along the jawline, not torqued downwards. If you place your finger along my jawline you can feel the tip of the wing beneath the jawline at a downward angle, thats is why I was wondering if it could have hit some tissue or something? like a wall then the only way to go for the wing was down?
He also said going through the mouth you are going in blindly so it hard to place perfectly (thought to myself then why didn’t you place it from under the chin?…)
He took pictures of my front and side views, to see if it is swelling or a misplaced cheek implant, and told me to come back in 2 weeks.
I am glad you said it is not unusal for one cheek to be more swollen than the other, so you are saying this would cause one implant to look more bulged out than the other one right?
Thank you so much doctor! you should feel good about calming all of us that are in such a bad way mentally about these problems.
If I ever get the chance to recommend you I will without hesitation!
Jesse :: 1 year, 5 months after
Jesse,
Thanks. No, there are no tissue walls to block proper placement of the chin implant. You lift the covering of the bone and make the appropriate space for the implant. I don’t use or like the intra-oral approach for chin implants for a variety of reasons.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 5 months after
I had cheek implants 2 months ago, and still have facial nerve pain - how long should I wait before I have to worry about it being permanent?
THANK YOU
Gina :: 1 year, 5 months after
Gina,
It’s a bit unusual to still have nerve pain after 2 months with Cheek Implants, in my opinion. You may want to see your Plastic Surgeon who did the cheek augmentation and get his/her take on the issue. Let us all know how it turns out.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 5 months after
Hello, I also had cheek and chin implants, my problem is I am having upper lip weakness and numbness in the upper lip, like I can’t puff out my cheeks fully without holding my upper lip down, like theres no pressure, or spit right ect, or pucker right, I can’t keep my upper lip down with resistence when I push it up, I can do all these things but not fully it seems with pressure (pucker, puff out cheeks ect)
Is this common or uncommon after these procedures? should I be worried? It’s almost been a month now… thanks in advance
Justin
Justin :: 1 year, 5 months after
Justin,
It’s not uncommon to have that for a month or 2 after cheek augmentation with cheek implants that are placed through the mouth. You can also have temporary weakness of the lower lip from the chin implant and both could be causing added issues but this should be temporary. If you’re concerned however, you should bring this up to the plastic surgeon that did your cheek and chin implants.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 5 months after
Hi Dr. Palmer,
I had a jaw implant attached to the left side of my jaw bone about a year ago. This implant was to improve the side effects of mandibular prognathism. I have severe asymmetry and the implant was to minimize this appearance. After one year post-op, I am still unhappy with the results. I chose to use an implant versus jaw surgery because I had a tough experience with oral surgery when I was 15 years old. I am 25 years old and I now have made an appointment with an oral surgeron. I’m reconsidering jaw surgery again. My question for you is: Will skin sag once my implant is removed? I have a quite large implant screwed to my jaw bone. Also, what are some other side effects of removing a jaw implant one year post-op?
Thank you for any insight!
Kristin
Kristin :: 1 year, 5 months after
Kristin,
The Oral Surgeon will have some definite answers for you during your consult but in general there would be some extra skin after the jaw inplant was removed. The younger the patient , say in 20’s, the greater the chance this extra skin would tighten back up. Good Luck.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 5 months after
Dr. Palmer,
I’ve searched all over the internet for information and support regarding chin implant problems, and you seem to be the only help available. Thank you for publishing this blog.
I’m a 40 year-old female and have been going to a cosmetic surgeon in my area for a few years for Botox and Restylane. I asked my Doctor about Thermage for some skin laxity and he suggested a chin implant instead. We did decide to add the Skin-Tyte procedure to this. (4 sessions)
Six weeks ago I got the chin implant (I think small silicone) through an external under-chin incision, and some liposuction under the chin along with the first session of the Skin-Tyte.
At this point the under-chin/neck sagging and profile is improved a bit. However, the overall shape of my face has me truly upset. I feel that the implant has aged me about 10 years.
My face is squarer (and I think more masculine) from the front and now marionette lines have appeared around my mouth, but more like folds.. I feel that the skin is pulling at my mouth, making me scowl. Food is getting caught in the now larger space in front of my lower teeth. And it even seems to be pulling at my eyes a little. I can barely smile due to the skin tightness and it is interfering with my speech.
At first The Doctor was assuring me that all this was due to swelling, but it is not getting any better.
My question is, have you seen chin implants dramatically change the way the skin lays on the face, and what would be a possible course of remediation? If I have the implant removed will my chin and neck start to sag? Do you think about the next 3 sessions of the Skin-Tyte might help?
Thank you!
Mae
Mae :: 1 year, 5 months after
Mae,
It’s not uncommon to have restricted facial movement after a Cheek or Chin implant. This typically resolves over 2-6 months. The appearrance is another matter and one you’ll need to discuss with the plastic surgeon that did your chin augmentation with an implant. If after a reasonable time (several months) you don’t like the look….you might consider removing the chin implant. It’s unlikely that a chin implant would effect facial tissues around the mouth causing sagging….removing it however might.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 5 months after
Dr. Palmer have you heard of Livefill Filler? Do you perform this in your office? it’s suppose to be permanant filler, The only one I have heard that does it is Dr. Molleken
Do you also perform midface life or cheeklift? can this be done after the buccal fats pads have benn removed?
Thanks
Jesse :: 1 year, 6 months after
Just read my message and full of spelling errors sorry, was rushing through…want to make sure you know what I’m saying..
Dr. Palmer have you heard of Livefill Filler? Do you perform this in your office? it’s suppose to be permanent filler, The only one I have heard that does it is Dr. Molleken
Do you also perform midface lift or cheeklift? can this be done after the buccal fats pads have been removed?
Thanks
Jesse :: 1 year, 6 months after
Jesse,
Have not heard of Livefill and am not a big fan of any permanent filler. The problem with all of them is that the tissues of the face shift with age…I figure after 3-4 years and the permanent filler becomes part of the aging problem in the nasolabial folds and not part of the solution. I do a “Celebrity Lift” faetured on “The View” and shape the cheeks with Cheek Implants or Radiesse Injections because I believe this to be far superior to any cheek lift. In extreme cases of facial aging, I do perform midline facelifts but not at the sub-perieosteal level as this causes the “cat-eye” deformity.
Read more here: http://www.drfpalmer.com/PalmerCelebrityLift.html
You may want to come in for a consultation to address your specific needs. 310-652-9583
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 6 months after
It says the Radiesse Injections last 12-24 months, excuse the silly question but would it last that long if I work out a lot and sweat + use a sauna- steam room? Will the injection be aborbed or go away?
I am a male and my cheeks have gone flat at 39 years old. My current cheek implants did not help because the PS placed them high on my cheek bone which did not address the flatness by the nose and submalar. Which was my real concern and hence the questions I have been asking.
I take it you would remove my current cheek implants and put in ones that actaully make my cheeks look fuller in the submalar region, then use the injections, is there an email where I can send you some pictures then you could give me your opinion on what I need and the cost? I would need to plan this out to come to California.
Thank you Dr Palmer
Jesse :: 1 year, 6 months after
Jesse,
The sauna and working out won’t effect the Radiesse and I would typically use one or the other (Cheek Implants or Radiesse), not both. Yes, I think you might consider removing and replacing the cheek implants. Yes, we have patients from all over the world and as such offer the ability to e-mail us jpeg pictures at drfpalmer1@aol.com and then schedule follow up telephone consultation (310-652-9583) where we discuss the pictures, your options and the costs. With Cheek Implants, we would ask that you stay in the LA area for about 1 week after your surgery. After that time, you could fly home.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 6 months after
I will take the pictures tonight and send them, Then tommorrow I will schedule a consultation with you.
Thanks
Jesse
Jesse :: 1 year, 6 months after
That would be fine.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 6 months after
Hello Dr. Palmer,
Thank you very much for your time in giving us much needed info.
I’m a 39yr old female. I had cheek implants combined with Radiesse a month ago. Implants were silicone (implatech), Med size 4.
I think my face looks odd, seems like my cheeks are too wide (seem wider than my temples)and too puffy.
Dr said a week ago that I was still swollen & that I would be happy w/final results.
My relatives so far don’t like them since it makes my round face look fatter & my eyes look sunk.
I have problems with the middle of my upper lip, can’t speak very well and I don’t have much of a smile.
How long should I wait for final results?
How soon can I remove them?
Will I get my smile back once they’re removed?
I have been unemployed for several months & was hoping that a month after the surgery I was going to be ready to go back but now I don’t know if I should remove them now to avoid sagging before getting a new job.
thank you,
silvia
silvia :: 1 year, 6 months after
Hey Silvia,
OK…let’s take a deep breath first.
1. You may want to wait a couple more months until you see the final result. From an aesthetic standpoint, I like the Large sized cheek implants from Implantech 3 or 4 mmm’s for women. The medium may make the face appear a bit angular. However, this is my opinion. Your Plastic Surgeon may feel otherwise.
2. If the cheeks appear too wide, the implants may be placed a bit too lateral (towards your ears)…I don’t know as I didn’t put them in…but after a couple more months you’ll basically have what it will be.
3. Smile, speech and facial movements can all be a bit off for the first couple of months….should resolve slowly.
4. No real timeframe to have them removed but logically, I’d say 3-6 months….by then the tissues are healed so another surgery can be performed assumming you still don’t like them. You may want another opinion at that time.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 6 months after
Hello Dr. Francis R Palmer I`m a 25 year old woman I had my cheek implants done in 2002 in L.A, one is higher than the other and i think there a pit small for my face .is it Possible to have them removed and replaced by new ones ? what is your Opinion on that ? how can you choose cheek implants that are right for me ?
Sophia :: 1 year, 6 months after
Sophia,
The fact that the cheek implants are too small for your face is the primary reason to consider removing and replacing them… That’s not to say that bigger is always better when it comes to cheek implants but certain sizes do, in my opinion, make a face appear soft and feminine.
I’d have to see a picture of your face, know what type of cheek implant you currently have and the size in order to make further determinations of what would look good in your case. You can e-mail pics to the office staff at drfpalmer1@aol.com
You can find out the type, style and size of the implant from the plastic surgeon who did the cheek augmentation. If they are silastic, they are easy to remove and replace.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 6 months after
Dear Dr. Palmer,
I had chin augmentation just over 3 weeks ago. It is a silastic implant with 5mm projection. The surgery was done through an oral incision in my mouth. The stitches have not dissolved after 3 weeks either… The result is an improvement to my face and I don’t have any swelling on my face. My problem is that I feel incredible tightness and rigidness under my lower lip and all around my chin. When I smile, I look sad and it’s no longer MY smile. This has been really depressing for me. I’ve gone to see my surgeon twice now and he’s said that there’s no sign of infection and evrerything appears to be healing well. He’s vague and he doesn’t seem to answer my questions about WHAT IS GOING ON INSIDE THAT area. I really hope you can shed some light on this for me. Thank you so much.
Rav :: 1 year, 6 months after
Rav,
I don’t place chin implants thru the mouth for various reasons, the least of which is increased swelling in the area below the lower lip and the possibility of implant migration into that area. You may want to see the plastic surgeon that di your chin augmentation and have him/her take a look and tell you everything is cool.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 7 months after
Thanks Dr. Palmer. I had another query. On the left side of my chin I can feel a harder bump than on the right. I believe this is the implant. The left side also has a feeling of “pulling” and a lot more discomfort than the right. When I trace my finger along the right side of my jaw and chin area it feels smooth and I cannot feel the implant and the “pulling”/tight sensation is a lot less. In your professional opinion, why is this? Thanks.
Rav :: 1 year, 7 months after
PS. That hard bump is actually more on the side of the chin where the implant is tapering I guess.
Rav :: 1 year, 7 months after
Rav,
Not sure, could be that the one side is healing slower. Consider asking the plastic surgeon that did your chin implant surgery this question.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 7 months after
Hi Dr.,
I wrote before regarding my cheek implants. It’s been 2 months & i’m still not happy with the look and still worried to death about my upper lip. I can smile, it looks and feels forced but I can smile. I’m still having a hard time pronouncing certain words and eating (upper lip feels heavy and still cant pout). Dr said I was one of those rare patients that heal very slowly. He wants me to wait one more month. One more month seems eternal to me because I’ve been hiding from everybody & the people that have seen me keep asking me WHY in the world did I elected to do this if I was beautiful (?) before. Part of me WANTS to believe that all of this will be resolved in a month but ALL of me thinks it will not since I haven’t seen any change in two weeks. Is it reasonable to wait one more month? If I need a second opinion, would you be able to tell me if the implants were too big for me and if I needed them in the first place? (I personally don’t think I needed them because I had fat cheeks but some how got convinced that these were going to improve the look of my under eye circles)
Please let me know if you can help me make a decision about these implants & what you need to know before scheduling an appointment.
thank you
Silvia :: 1 year, 7 months after
Silvia,
Hopefully, the nerves will all come back in your upper lip…they typically do and can improve for a year or two after the cheek augmentation….so don’t despair just yet. This is of course a separate issue of whether the cheek implants are too large for your face or you like the final result.
Yes, I can evaluate your face and the cheek implants. I’ll need a picture of your face front view before the cheek implant surgery and the type and size of the cheek implants that were used. Example would be silastic implants from Implantech TMSL3. This information can be obtained from the nurse at the plastic surgeon’s office that performed the surgery.
You can e-mail us the pictures (can include a post op as well of face from front) and the implant info to drfpalmer1@aol.com You then call the office at 310-652-9583 and schedule a phone consultation with me to review my findings and opinion. This is second best, of course, to me seeing you in person which allows me to not only evaluate the cheek implants and your face but let’s me gauge the level of weakness in your upper lip.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 7 months after
Hi there Dr. Palmer.
I am a fellow doctor (Radiologist) who has actually scheduled myself in for surgery in the near future. I have a mid sized silicone chin implant lined up and chin liposuction. I only recently have I learned of the potential complication of bone resorption and wanted to know how much of a potential complication rate there is. My surgeon was planning a submental approach and placement above the periosteum without fixation (screws etc). Also what is the satisfaction rate in terms of cosmesus?
I am very tempted after reading the high number of unhappy stories out there to stick with lipo alone and stick with my chin of 35 years.
Thanks in anticipation.
Regards
J
J :: 1 year, 7 months after
J,
You can try the submental lipo and see how much that does…certainly. Here are the basic facts about chin implants.
1. they are quite safe and reliable…quick surgery and quik recovery if performed thru a submental incision…not intr-oral. I only use silastic implants.
2. there is a small chance (not sure the %) that will cause erosion of the mental bone….if this happens the implant should be removed. At a recent conference, the latest thinking is that the implant doesn’t erode the bone but rather causes some increased bone formation. Placing the implant above the periostium is thought to decrease that but that’s just theory.
3. the implant is typically secured by placing it below the periostium and if placed above, in my opinion, is much more likely to shift, move and be seen/felt thru the skin.
I have done many chin implants for over 20 years and consider them safe and highly effective with very little risk of erosion or shifting if placed directly on the bone.
Nothing, as you know, in medicine is without risk. I would have a chin implant or do this on a family member…if that helps you place it in perspective.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 7 months after
J,
I did want to add that in my expeience, the vast majority (99%) are thrilled with their chin implants…but other surgeons may have other experiences.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 7 months after
Hi Dr. Palmer,
My name is J and I live in Orlando, Florida. I am turning to you to see if you may know the cause of this problem that I have. I had cheek implants back in 1994 and I had them removed about a couple of months after the surgery. Over the last 14 years my cheeks are still swollen and have never returned back to original, even after removing the implants. My cheeks are sometimes more swollen on some days and less swollen on other days. I do not know what is causing this? And I would like to simply have my original flat cheeks again. I would be willing to fly out to you for consultation so you could look at them, and or possibly a answer to the cause of why my cheeks remain swollen. At the end of each day, my face swells down, then when I wake up the next morning they are swollen again. This has been going on for 14 years! Please help Dr. Palmer… Regards, Jamie.
J :: 1 year, 7 months after
J,
Wow, this is extremely unusual and I don’t think related to the 2 months that you had the cheek implants in place now still causing issues some 14 years later. I think you should see a good Ear Nose and Throat doctor in your area for a comprehensive work up of your salivary glands including the Parotid glands. I’d look for a medical explanation and rule that out at this point.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 7 months after
Just wanted to say thanks very much for your input Dr. Palmer. I have been away hence the late reply, but I didn’t want your input to go unthanked.
Kind regards
Justin
Justin :: 1 year, 7 months after
Justin,
You are welcome…hope it helped.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 7 months after
Dr Palmer,
Do you, with your subperiosteal approach use screws to anchor the prosthesis? Would you recommend fixation for an implant if it is above the periosteum? Thanks
J
J :: 1 year, 8 months after
J,
I place chin implants thru an incision below the chin and under the periostium only. In this manner they don’t require srews or other fixation methods nor is there a high degree of bone formation or absortion. Placing the chin implant above the periostium may require srews to fix the implant or it most likely would feel mobile within the soft tissues over the chin. FYI…I’m not aware of any data that shows placement of the chin implant above the periostium is superior to placement below.
Dr. Francis R Palmer, III
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 8 months after
Dr. Palmer,
I received a chin implant through an oral incision in my mouth 12 years ago. I have never had any problems. However, after reading questions on this blog, I wonder what effect my implant could have on my lower front teeth? Over the years, my lower front teeth seem to be “pushing up” more, weakening and having more soft spots. Could this be a direct result of the implant? I’m worried and not sure if my dental problems are a result of the implant. Thank you for your time.
Tal :: 1 year, 8 months after
Tal,
You can have your dentist do a panorwx X-Ray of your chin to see if the implant is causing bone erosion.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 8 months after
Hello! I just got a chin put in and Im not sure if Im starting at it too much or if I am freaking out too soon, But is it normal for the different sides to heal differently and look differently for awhile? One side it alot more rounded and squared and I can feel that it is still heal and i can feel the foreign object in my chin when i smeak/eat. The other side however has more of a shape to the jaw line, it goes in more when the it come toward the chin. And I feel like it has completely healed, Its not soar and It feels as if nothing at all has even been but in on that side! Please let me knoe if this is normal…I just hope there hasnt been some sort of shift. I dont know how that would happen when I havent really done anything too it.
Gonz :: 1 year, 8 months after
its me again…to describe the rounded side better, It almost feels like theres an air bubble under the impant. or as if my glands swollen. I can feel it when i move my head and chew. NORMAL?
Gonz :: 1 year, 8 months after
One last thing….it feels like my jaw is being pulled to one side.
Gonz :: 1 year, 8 months after
Dr. Palmer,
I had cheek Augmentation surgery w/ small silicone implants approx. 2.5 weeks ago. The swelling (where the implant was placed & below) is still quite noticeable. The incisions were placed through the upper lip. My main concern is every time I smile…my upper lip seems to turn down somewhat & I cant create a full smile as I did prior to surgery. Is this normal? Also, I feel as if I have trouble forming words (due to my upper lip). I am worried because I have an important business event to attend in about one month & hope this will mostly be resolved. Any advice would be greatly appreciated. I can also send you before & after photos. Your website has benn a blessing to me & to other concerned patients.
Thank you,
Lisa
Lisa :: 1 year, 8 months after
Gonz,
In my hands, Chin Augmentation with Chin Implants heal very quickly. If you are having these sensations and symptoms, you should see the plastic surgeon that did the Chin Augmentation and ask for his/her assessment.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 8 months after
Lisa,
This is quite common. The Cheek Implant sits atop the muscle that lifts the upper lip and the resistence is most likely what you’re feeling. This slowly resolves over 1-3 months. I have my Cheek Implant patients use their mouth as normal during the post op period. If it persists or you are very concerned something is wrong, go see the plastic surgeon that did your Cheek Augmentation.
I do many of these surgeries and have for over 20 years. I also have the patients sleep on a U-shaped pillow for 1 month after the Cheek Augmentation woith implants to avoid sleeping on the implant and possible shifting.
You can read more about Cheek Augmentation here:
http://www.drfpalmer.com/CheekImplants.html
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 8 months after
Hi Dr. Palmer,
I am a 34 year old male with relatively flat cheeks that have hollowed with age. I’m also hollow in the lower eyelid region, in part due to a lower blepharoplasty I had several years ago. I consulted several surgeons. Most recommended fat grafting to the lower eyelid region, but I received a very diverse set of recommendations regarding the cheek area. One surgeon recommended medium cheek implants, another large or XL implants, while two other surgeons recommended fat grafting and told me to stay away from the cheek implants.
Below are a bunch of general questions. I know I’ve asked a lot so please don’t hesitate to answer as few or as many as you like. Thank you in advance!
- In general, when do you recommend fat grafting to the cheek vs. an implant?
- Do cheek implants make hollowing under the lower eyelid look worse?
- Does the outline of the cheek implant become visible or does the implant’s projection look unnatural as our faces hollow with age?
- Does placing fat into a flat cheek further weigh down the soft tissue and promote cheek pad descent or jowling?
- What has been your experience regarding the longevity of fat grafting to the cheek and lower eyelid? Can I expect the graft to last 5-10 years or beyond?
- Regarding lower eyelid hollowing, do you ever place tear trough or orbital rim implants? I’m curious as to why these implants aren’t promoted more as a permanent solution to lower eyelid hollowing or bony insufficiency in this area.
Thanks again.
- Dave
Dave :: 1 year, 8 months after
Dave,
Here goes:
In general, when do you recommend fat grafting to the cheek vs. an implant?
Dave, Fat grafting is not predictable, cheek implants are. I never use fat grafting and always choose an implant over fat. I know what I get with an implant…can’t say that about using fat.
- Do cheek implants make hollowing under the lower eyelid look worse?
They can if the cheek implant is too thick…this will depend on the aesthetic skill of the plastic surgeon and his expertise using cheek implants.
- Does the outline of the cheek implant become visible or does the implant’s projection look unnatural as our faces hollow with age?
Cheek implant is not visible…will not cause hollowing.
- Does placing fat into a flat cheek further weigh down the soft tissue and promote cheek pad descent or jowling?
Yes, logically the added weight of the fat will be effected by the pull of gravity.
- What has been your experience regarding the longevity of fat grafting to the cheek and lower eyelid? Can I expect the graft to last 5-10 years or beyond?
No, fat is dead tissue that may or may not live and could dissolve in an uneven, lumpy fashion. I don’t recommend this course of action for my patients.
- Regarding lower eyelid hollowing, do you ever place tear trough or orbital rim implants? I’m curious as to why these implants aren’t promoted more as a permanent solution to lower eyelid hollowing or bony insufficiency in this area.
No, these are not popular because they have problems. the skin of the lower eyelid is too thin to hide any implant or fat grafting.
FYI, read my Palmer Beauty principles. In my aesthetic opinion, large or XL cheeks will make the face look feminine…not apprpriate for men.
You can send photos to drfpalmer1@aol.com or call 310-652-9583 for a consultation and another opinion.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 8 months after
Dr. Palmer—wanted to know what your experience has been with using Radiesse for the jaw angles, to create square, masculine look, like Brad Pitt.
I heard you prefer Radiesse for this over silastic mandibular jaw implants. Why ?
Vincent :: 1 year, 8 months after
Vincent,
Yes, I have done many patients usinf radiesse to shape the jawline, jaw angle, chheks and chin. The jaw implants are quite problematic and I don’t offer them for that reason, so in the jaw area, Radiesse offers a great alternative.
Dr. Francis Palmer
drfpalmer :: 1 year, 9 months after
Hi Dr. Palmer,
Thank you for your reply. I reviewed the cheek implant section of your web site. It seems like choosing the proper size cheek implant is really critical to achieving a good outcome.
- What happens if I’m unhappy with the size of the implant? Is it easier for you to remove the smaller implant and replace it with a larger one or vice versa?
- I’m quite anxious about getting cheek implants and may opt for the temporarily filler Radiesse instead. How long would one typically have to wait to get cheek implants following a Radiesse injection?
OK. Thanks again. I’ll try to take some close up photos and email them to you.
- Dave
Dave :: 1 year, 9 months after
Dave,
Yes, the proper size and shape of the cheek implant is key to the correct aesthetic look. I use 1 shape and several sizes for men and women as these give the best results and make people look great without being over done…a real no, no with cheek implants. On the website, I list many types and styles of cheek implants as educational reference, not that I use them but for the reader to see the huge variation that exists in style, size and shape of cheek implants. Many of these, I believe to be aesthetically incorrect.
You will need to trust the aesthetic judgement of the plastic surgeon for your cheek implants. You can e-mail the office photos of your face from front view for evaluation.. drfpalmer1@aol.com
Radiesse is a great way to ease yourself into facial sculpting but placement and the amount of Radiesse, like selecting the proper cheek implant, is key for the right look. I typically use 1 syringe for each cheek, the Radiesse injections are done as an office visit and take about 5 minutes. 2 days later, you have great cheeks. Radiesse lasts 12 to 18 months.
It is very rare for me to remove cheek impants that I have placed…that’s because we spend soo much time discussing the proper size and shape with our patients. You may want to do this instead of guessinng and then planning on an exchange of the cheek implants if you’re not happy.
I have performed many cheek augmentations over the past 20 years with cheek implants and now using radiesse injections as well. You need a plastic surgeon with experience in this area and you’ll need to have a consultation to figure out the proper size and shape of the cheek implants, so you get it right the first time.
You can call the office at 310-652-9583 if you wish to schedule a consultation for cheek augmentation with cheek implants or with radiesse Injections.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 9 months after
Hi Doctor Palmer
I am 44 year old male, a little over 5 years ago I had a small chin implant and some lipo done. The implant was placed via an incision inside my mouth.
While I feel the placement of the implant was centered properly, it seems the wings along the jawbone never seemed right. on my left side it feels as though it tucks under the jaw, while on the right it runs along the side. I now more often than not experience pain in the area that the nerve passes through my jaw on my right, and pain on the left where I feel it has tucked under my jaw.
Is it possible that the implant can be pressing against this nerve and or the poor placement of the wings of the implant have caused some damage that I should be concerned about.
What action should I take if any?
Chris
Chris :: 1 year, 10 months after
Hey Chris,
That’s exactly what it sounds like and yes, the implant may be impinging on the nerve. Unlikely it will cause damage to the nerve but you may want to visit the plastic and cosmetic surgeon that placed the chin implant and get their opinion. Obviously you can remove the chin implant but also perhaps one that’s not so long might avoid the nerve.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 10 months after
Dr. Palmer,
Two years ago I had a chin implant placed that I’m not happy with. I feel that the implant is off center and is not the correct size/shape/fit for my face. Recently I have been considering getting this implant removed and replaced with a different shaped implant. I was just wondering if there would need to be time between these two surgeries (or if it could be done in one shot) and what your general thoughts are on removing and replacing an implant. Thanks!
Jenna :: 1 year, 10 months after
Jenna,
I often can take out the implant and place the new one without issues. It helps if you have the specifics of the chin implant…company, catalog number and size. You can e-mail us pictures at drfpalmer1@aol.com
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 10 months after
Hi there Dr Palmer,
My plastic surgeon put in a chin implant 3 months ago. The anterior part is above the periosteum with the wings on each side beneath the periosteum on each side to fix it in place. On day 2 ( when I as seen for follow up) and immediately after the procedure I could feel the left side was higher than the left but was reassured by the surgeon that it was in the correct place. now that the swelling has gone I know for certain on the left it is a good 8mm superior to the jaw line whilst on the right is exactly where it should be (on the jawline) giving my chin a slight angle.
The surgeon has a slightly patronising attitude in the past with attempts at false reassurance and as a medical specialist I am somewhat hesitant to be too hard on him but find it hard that he would fail to admit to error. I have been told I have uneven jaw line. well Ok maybe I do, but surely even if that were true the implant should still be on the jawline.
Should a revision be done would it would be done using the same impant?
If it isn’t done right the first time can there be any assurance that the second effort will be any better given the operative field is no longer a virgin one?
Thirdly I wanted to know in regards to the preop mark up, could an error have been made, as the line on my chin was off centre or is it standard to line up the implant with the patients nose/lip etc… or that an individual choice?
I am going to see the surgeon when he returns from a conference in the US so was hoping for some input prior.
Thanks in advance
J
J :: 1 year, 11 months after
J,
Let’s take these in order.
1. A revision Chin Augmentation could certainly be done and you should be the judge of whether, or not that happens. If you’re really not happy with the chin implant, you should consider re-positioning or replacing the implant. You didn’t tell me several key elements….what style and size is the implant, was the incision under the chin or inside the mouth and from what type of material is the implant made.
2. I place all cheek and chin implants below the periosteum but other plastic and cosmetic surgeons place all or part above as in your case. It is not unusual for any part of the chin implant to move a mm or so as the pocket is larger than the implant. It is a bit unusual for it to be 8mm shifted. Revisions whether chin or any implant are more difficult…in this particular, case the edge is 8mm above where you indicate the jaw line edge is…that means during dissection there will be even more room for the implant edge to move. I fix the implants externally with steri strips and you might need to have these on for 2 weeks straight. Even then, I’d make no promises that it wouldn’t shift.
3. Really, who knows. Pre-op markings are individualized by each surgen based on what he wants the marks to tell him/her.
Bottom line, if you hate it…fix it but as you can imagine…life and plastic surgery hold no guarantees.
Dr. Francis R Palmer, III
drfpalmer :: 1 year, 11 months after
Dr Palmer,
Thanks for the info.
Sorry I did cut out a few key details.
The incision was a below chin skin incision with a medium sized silicon implant put in place.
I don’t believe the implant has ever shifted. It felt and looked uneven from day 1- left side higher than right- and now I have a chin that looks like my right side is lower. Cosmetically it is subtle to others, other than myself. My wife says I look better etc but I am concerned about potential long term complications as the wing on the left is overlying the roots of the lower teeth/inferior alveolar nerve canal etc. Seco