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.
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, and the surgical consent form will be read to you. 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 7:15 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.