A younger face is more triangular in shape with the chin representing the tip of the triangle. With aging, as the malar areas decend, jowling occurs and the face shape becomes more rectangular. In individuals whose facial contours have changed as a result of advancing age, as well as in individuals who have congenitally flat cheek areas, malar or cheek augmentation can offer significant enhancement of facial aesthetics. Though implants offer the advantage of a permanent structural change, injectable materials may be a good alternative when a lesser degree of augmentation is sufficient and permanency of the result is not mandatory. In the future, with ongoing evolution of soft tissue fillers, injectable treatments may become an even better option with long-lasting results.
Determining Cheek Augmentation Goals
Over-augmentation of the malar area, unfortunately, is not uncommon. Old photographs that illustrate how a patient looked in younger years, before aging impacted the facial contours, may be helpful in determining the optimal enhancement. Similarly, images from beauty magazines can be useful tools for the prospective patient to communicate her or his aesthetic goals to the plastic surgeon during a consultation. Injection of saline, which will absorb quickly and harmlessly, into one side of the face is a further technique that can be useful to more accurately define a patient’s desires. When considering modifications to the cheek contour, and especially those that are to be relatively permanent, careful preoperative evaluation and good communication between surgeon and patient are essential components of a happy outcome.