The contours of the face are affected by the skin and underlying structures, including subcutaneous tissue, muscle, fat and bone. Occasionally, problems exist that cannot be addressed by altering the skin alone. For example, deficiencies in the cheekbones, jawbone, nasolabial creases and lips significantly affect a person's appearance. Many patients want to change these areas.
Most commonly, patients seek to augment one or more of the facial regions mentioned above to give a more youthful and defined appearance to the face. For augmentation procedures, we at Mayo use synthetic materials that have a track record of safety and efficacy. The nasolabial creases and lips usually are augmented with small, soft implants that are placed deeply in the skin and the underlying subcutaneous tissue.
Mayo surgeons typically perform the chin and cheekbone augmentation surgery through intraoral incisions. Occasionally, however, surgeons will do the surgery through a small incision under the chin. The material to augment these specific regions is then placed and fixed with internal sutures and, occasionally, external sutures.
The surgery for each of these regions takes from 30 minutes to 1 1/2 hours. Most are performed using local anesthesia with sedation or general anesthesia. Following surgery, the patient remains in the recovery room for a period of time and then may return home with a responsible adult. If the surgery is performed with other procedures, overnight observation may be required.
The main risk to patients with synthetic implants is postoperative infection. Meticulous surgical technique is used to help prevent this complication. When synthetic material is implanted, the patient is usually placed on antibiotics after surgery to prevent infection.
Intraoral sutures dissolve on their own five to 14 days after surgery. Any external sutures are removed after surgery. There may be some swelling and bruising in the augmented region. Discoloration takes about one to three weeks to resolve. The swelling may take a total of several months to entirely resolve. Rarely, the implants will shift during the healing phase and need slight repositioning.
Some studies have shown slight bone erosion under some implants placed on the cheekbones or chin. However, this has not been shown to be of significance to the patient over the long term. There have been no reports of any systemic disorders or medical abnormalities caused by using synthetic materials for facial contouring, although there may be associated numbness in the surgical region. This resolves over a period of months. Permanent numbness is an extremely rare complication of these procedures.
Less often, a patient seeks reduction of the cheekbones, jawbone, or lips. This is usually done by contouring the underlying bone or removing excessive skin and subcutaneous tissue. In reduction procedures, there is no associated placement of augmentation material.
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