With the advent of injectable fillers for facial volume augmentation, the popularity of permanent facial implants has diminished. However, since all of the FDA approved injectable fillers are temporary (typically 6-24 months for hyaluronic acid gels, for example), sometimes a permanent implant makes more sense.
In addition to the lack of ongoing maintenance and potential for fluctuation in appearance, permanent implants offer another benefit. They can provide support for aging, sagging, or damaged soft tissues in a way that gels just cannot. As a consequence, implants continue to have a place in both cosmetic and reconstructive oculofacial plastic surgery. Dr. Fante has given courses on permanent facial implants to his colleagues at national scientific meetings, and has experience with many types of implants.
Types Of Facial Implants
Depending on your specific needs, Dr. Fante will help you decide which type of facial implant will help fix your problematic area.
Permanent chin implants can be placed as part of face and neck lift, or as a stand-alone procedure. They obviously improve the projection and the shape of the chin for people in whom the chin is weak, but they also usually enhance shape of the overall jawline and neck. They are implanted either through a small skin incision in the submental crease (the natural crease that forms under the chin) or through a small incision inside the mouth at the base of the lower front teeth.
Either way, Dr. Fante positions the implant carefully to avoid interference with lip movements, facial expression, and sensation. Multiple sizes and shapes are available, and you can see samples during your consultation with Dr. Fante.
Permanent implants can be placed along the cheekbones or adjacent to the border between the cheek and the lower eye area to improve facial shape and fullness. They are available in many sizes and shapes, and are customizable for your face. They can be placed as part of eyelid, cheek, or face lift surgery, or performed as a stand-alone procedure.
Sunken temples are one of the many signs of advancing age. They are also sometimes seen after certain types of neurosurgery and accidents. Emptiness at the temples may be more obvious is people with thin faces and shorter hair. Dr. Fante can place restorative implants behind the hairline, and can permanently improve appearance.
Disappearing lips can be a concern for both men and women as they age. Most of us lose volume in the lips, and this together with the effects of sun, frequent movement, (and tobacco for those who use it) causes vertical lip lines, loss of definition at the border between the vermilion and the skin, and general shrinking of the lips. Lip augmentation with temporary hyaluronic acid fillers (such as Restylane, Juvederm, Belotero, Perlane, etc) is very popular but requires maintenance injections every 6-12 months.
Permanent lip implant technology has evolved as well, and permanent improvement in lip shape and size can now be accomplished in a simple office procedure using local anesthetic. The new implants are soft and discreet, and of course, come in many different sizes. Like the filler injections, the permanent implants do not interfere with lip movement or sensation, so that kissing, speaking, eating, and smiling do not change.
Facial Fat Injections
For almost all of the situations described above, it is also possible to use your own fat to improve volume loss in your face. We call this “autologous” fat. Dr. Fante can take this fat from your belly, hips, legs, or neck with special liposuction. Then, Dr. Fante will carefully inject the fat into your face with special instrumentation.
Dr. Fante can do this in a single procedure in the privacy of our office suite, or at an ambulatory surgery center or hospital, as part of other facial rejuvenation surgery (such as eyelid or face lift) or as a stand-alone procedure. We know that some of the fat will not survive during transfer, but much of it will survive, and will then live permanently in the new location.
Many people will have substantial improvement in facial volume loss from just one fat transfer procedure. Others may require more than one. Your own fat has several advantages, including a perfectly natural feel, and that it naturally carries stem cells with it. These stem cells will sometimes create an improvement in your facial skin appearance. While not for everyone, autologous fat transfer is an exciting development in the practice of oculofacial plastic surgery.
Are Implants Safe?
While the problematic breast implants are liquid silicone that leak, facial implants have solid silicone (that can’t leak) or from porous polyethylene plastic. Both materials have a long track record of safe use throughout the body in millions of patients. As for any implanted foreign body such as screws, pins, and artificial joints, there is a small chance of infection from dental procedures and other surgery, and so you would want to ask your doctor whether prophylactic antibiotics might be advisable.
Recovery From Facial Implant Surgery
Particularly with older people, we see that recovery can be longer, even double in time, after extensive fat transfer procedures. Dr. Fante will do his best to fully inform you about the recovery from any of the facial implant options you are considering.