Chin and Cheek Implants
Facial implants are the best-kept secret in facial cosmetic
surgery. While they are useful as stand-alone procedures to
improve facial balance by building up weak cheeks or a weak
chin, they are often used in conjunction with other procedures.
Common combinations include adding a chin implant to rhinoplasty
to balance the profile, or to facelifting or liposuction of
the chin/neck to improve the quality and durability if the
lift.
Because we recognize beauty in the face as a whole, the addition
of a chin implant to a rhinoplasty or a mini facelift is often
the difference between a fair overall result and an outstanding
overall result.
While many people fear looking “like Jay Leno,”
a well-done chin implant is very natural looking and natural
feeling. After the healing process, the chin implant looks
and feels like any other chin.
Chin and cheek implants are solid, don’t leak, and
usually last a lifetime. While most patients love their new
look, it is important to note that facial implants are one
of the few reversible procedures in facial cosmetic surgery;
they may be removed completely at any time, even years later.
As with most of our surgical procedures, Dr. Nayak performs
most facial implant procedures procedures in our in-office
AAAHC-accredited operating suite under local anesthesia or
mild sedation. For patients who would like to be more deeply
sedated or fully asleep, Dr. Nayak prefers Frontenac Surgery
and Spine Care Center or St. John’s Mercy Hospital.
The Consultation
During your consultation for chin or cheek implant surgery,
Dr. Nayak will ask you what about your middle and lower face
bothers you, and may also ask you to talk about other, related
areas of your face, such as your lower eyelids, nose, jawline,
or neck Dr. Nayak will likely ask you to point out, very specifically,
what you’d like to see changed. Identifying exactly
what needs to be addressed is the cornerstone of good results!
Dr. Nayak will then review your medical history form, and
may ask for some additional information from you. Current
and past smoking habits, or the use of nicotine gum or patch
products, are especially important to mention to Dr. Nayak
during this part of the consultation as nicotine dramatically
reduces the chances of proper healing. Dr. Nayak will also
pay special attention to parts of your medical history that
need to be considered carefully when undertaking facial implant
surgery, such as uncontrolled high blood pressure, or any
medications or supplements you may take that thin the blood.
In general, all over-the-counter pain/fever reducers (except
Tylenol) are off-limits for 2 weeks before and after facial
implant surgery, as are ginkgo biloba, St. John’s Wort,
or high doses of fish oil, flax seed oil, or vitamin E.
The Physical Examination
Dr. Nayak will then examine your face and neck to determine
exactly what must be corrected to achieve optimum results.
He will also show you samples of the types of implants used
today, and where the reside in the face.
In addition, should you desire improvements of the eyelids,
brows, nose, jawline, or neck areas to achieve balanced results.
Dr. Nayak will take a few moments to discuss these options
with you to make sure they meet your personal esthetic goals.
The Preoperative Visit
Once you have decided to undergo facial implant surgery,
Dr. Nayak’s staff will help you schedule your surgical
date, and, about 2 weeks preceding that, a preoperative visit.
Expect to spend about 90 minutes in the office on the day
of your preoperative visit. During this visit, you will be
educated on before instructions, after instructions, and prescriptions.
Written copies of all of these will be given to you at this
visit, as well, and you will be able to fill your prescriptions
ahead of time. You will also be reminded at this time to avoid
for 2 weeks before and after surgery any medications and supplements
that thin the blood.
Also at the preoperative visit, your private preoperative
photographs will be taken, the surgical consent form will
be read to you, and you will have an opportunity to discuss
with Dr. Nayak any questions you still have remaining. Finally,
at the conclusion of this visit, the balance of your surgical,
facility, and anesthesia fees will be due.
The Surgical Visit
In general, you will be asked to arrive at 7:30 AM the morning
of your planned surgery. If you are having your surgery at
an outside facility, you may be asked to arrive earlier. You
should have nothing to eat or drink (not even water, candy,
or gum) after midnight the night before your procedure.
If Dr. Nayak prescribed antibiotics, oral sedatives, or if
you take blood pressure medication in the mornings, you may
take these with a small sip of clear water.
You will need an adult driver on the day of your surgery
to bring you and to take you home. Your companion may wait
in our comfortable reception area, watching TV, reading, and
enjoying coffee, soda, and snacks. Alternatively, if your
companion wishes to leave a cellular telephone number, we
can call him or her with updates and also at the conclusion
of the procedure.
Upon your arrival, Dr. Nayak’s staff will greet you
and review your medical history, looking for any new changes
since your initial consultation. Dr. Nayak and his staff will
also confirm that they and you are in agreement about which
procedures are to be performed, and those areas will be marked
with you sitting upright in a chair. If you are a woman under
50 and have not been surgically sterilized, a urine pregnancy
test may be performed. In any case, you will have one last
opportunity to have last-minute questions answered and use
the restroom, and will be escorted to our AAAHC-accredited
surgical suite.
Once there, you will be positioned comfortably on your back,
with pillows behind your knees and under your neck. Blankets
are also available if needed. You may also bring your own
iPod or CD’s, or listen to our choice of soothing music.
Painless blood pressure and oxygen monitors will be placed
on your arm and finger, and massaging air-filled stockings
will be placed on your legs and thighs to encourage excellent
circulation while you are lying down. Most patients truly
enjoy these stockings and find them very soothing.
Dr. Nayak and his staff will then perform one final “time-out”
aloud to ensure they are about to embark on the appropriate
procedure on the appropriate patient. Your chin and/or cheek
areas will then be slowly, gently numbed with local anesthesia,
and sterile towels will be placed around your face and neck.
By this time, most patients feel very relaxed. Once numb,
the majority of patients actually fall asleep intermittently.
Those who do not remain relaxed but awake, and Dr. Nayak and
his staff get the welcome opportunity to talk with you during
the procedure.
Dr. Nayak will begin the procedure by making an incision
through which to place the implant. Cheek implants are placed
through incision hidden in the mouth, while chin implants
are placed through an incision hidden under the chin crease.
After placement of the implant, the area will be rinsed with
antibiotic solution and the incision meticulously closed.
Your Recovery – Day 1
At the conclusion of your procedure, Dr. Nayak will tell
your companion how everything went, and he or she will have
the opportunity to see you. You will be mildly bruised and
swollen at this point. No dressings will be used unless other
procedures have been performed together with the facial implants.
You will be asked to spend 1 hour with us prior to being
discharged. Dr. Nayak will call you the evening of the procedure
to check on your progress, and you will also be given Dr.
Nayak’s personal cellular phone number in case questions
should arise after hours or on the weekends.
Your Recovery – Week 1
Most patients feel no pain whatsoever immediately after surgery.
Many patients find they nap intermittently the first afternoon.
Later in the evening, most chin implant patients report a
feeling of tightness or soreness along the the front of the
chin when chewing.
Most patients take their prescribed pain medication for 24-36
hours after the procedure, and then switch to Tylenol –
all other over-the-counter pain preparations are off-limits.
Many patients take Tylenol alone right from the start, while
a few require the prescription pain medication for 3-4 days.
If facial implant surgery has been performed by itself, there
is no need for a checkup the day after surgery. If other procedures,
such as a facelift, were performed, you will be asked to come
to the office for a dressing removal and checkup visit.
You will be able to shower and get all sutures wet the first
day after surgery, as soon as you have your dressing (if any)
removed. You will be asked to use intermittent cold compresses
and sleep with your head elevated for the first few days.
On the 6th or 7th day after surgery, you will return to the
office for a painless suture removal visit. If you have significant
bruising remaining at this point, it may be treated with a
laser to hasten its disappearance.
By the 7th day, women may wear makeup, men may shave, and
almost everyone is “presentable” to run errands
or go back to work. Especially easy bruisers, or patients
over 65, may require another 2-3 days for most of the bruising
to resolve. By 2-3 weeks, most people are “undetectable”.
If you are not self conscious about being seen with bruising
or sutures in place, or work from home, expect to be back
to work within 3-4 days!
Your Recovery – Long Term
Over the ensuing weeks and months, you will find the incision
line under your chin, if present, heals gradually. You will
become less and less aware that your chin or cheek implants
are even present.
Facial implants are one of the few procedures in facial plastic
surgery that are truly permanent. While there is a low risk
of infection requiring implant removal (1-3%), most facial
implants remain in place for a lifetime.
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