Some patients age prematurely because of a lack of support of the soft tissues of the face by the facial skeleton. Early aging in this regard is analogous to the collapse of a roof in a rainstorm that has insufficient beams to support the structure. As we age and the effect of gravity causes a forward and downward migration of soft tissues on the face, distinct lines (rhytids) form. If a patient is born without prominent cheek bones, they tend to lack the taper of facial form of an upside-down triangle. In youth, patients may appear to be flat in the tissues lateral to the nose and slightly hollow underneath the eyes. However as the individual ages, the cheek fat pad which initially sat over the prominence of the cheek bone tends to fall into an area forward, down and close to the nose. This phenomenon causes the classic aging characteristic of deepened “nasolabial fold,” or the line that patients call their “marionette line.”
For the treatment of a patient with adequate size and shape of the cheek bones, the treatment of this condition involves precise repositioning of their cheek fat pad in the vector, or direction, from which it migrated over the years.
However, in patients with inadequate cheek bone size and position, “pulling” the cheek pad up and back will shortly result in relapse. As the analogy continues, reinforcing the shingling on the roof will not help support the weight of the rain. Rather, we recommend that we enhance the facial skeleton by augmenting the cheek bones. This is simply done by placing precisely sized and positioned cheek implants.
There are many techniques for the placement of facial implants, however most lack the ability to precisely examine the native underlying bone, alter asymmetry and carefully position both cheek implants under direct vision to achieve symmetry of size and position. Dr. Lee‘s technique is to create a small access opening to the cheek bones from inside the upper lip. The tremendous advantage to this access point is that it is painless to the patient, it does not leave a noticeable scar and it allows direct visualization of the patient’s cheek bone structure, alteration of asymmetry and precise positioning and fixation (with bone tacks) of the implant.
Once healed, the implants look and feel like the patient’s normal bone structure. The oral incision is closed with sutures (stitches) that are resorbable (melt away on their own). For patients undergoing a simultaneous facelift, this allows phenomenal support of the cheek fat pad and not only enhances the initial result, but more importantly, enhances the longevity of the result. Results simply last longer.
Read more at American Academy of Cosmetic Surgery’s website: