How Cheek Augmentation Surgery Is Done: Implant Placement Through the Mouth or Lower Eyelid

The moment usually arrives in a bathroom mirror, under a light that is too honest. You tilt your head, and the face that once had a gentle rise beneath each eye now looks flatter, a little tired, as if the volume drifted south while you were busy living. Filler helped for a while. Then someone mentioned implants, and the questions started multiplying.

The cheek implant surgery procedure is one of the older ideas in facial surgery, and also one of the least understood by the people considering it. Most of the confusion comes down to a single detail: how does a surgeon get a piece of solid material onto a bone that sits directly under the skin, without leaving a scar across the face?

The answer is that they go in from behind, either through the lining of the mouth or through the lower eyelid. This article walks through both routes, what happens on the table, what the following weeks usually feel like, and the honest downsides that rarely make it into glossy brochures.

What does the cheek implant surgery procedure actually involve?

Strip away the vocabulary and the cheek implant surgery procedure is a pocket-and-plate operation. The cheekbone, which surgeons call the malar bone, sits just beneath the skin and muscle of the mid-face. Over years, the fat pads that cushion it thin and slide downward, and in some people the bone was never especially prominent to begin with. An implant is a preformed piece of biocompatible material, meaning a substance the body tolerates without rejecting it, shaped to sit on top of that bone and lift the overlying soft tissue outward.

Getting it there requires three things. First, an entrance that will not leave a visible scar. Second, a tunnel down to bone that is wide enough to admit the implant but not so wide that the implant can drift. Third, a way of holding the implant still while scar tissue forms around it and locks it in place.

Surgeons work in a layer called the subperiosteal plane. The periosteum is the thin, tough membrane that wraps every bone like shrink film. By lifting it off the cheekbone and sliding the implant underneath, the surgeon parks the implant against bare bone, which gives the most stable, most predictable foundation and keeps it away from the skin, where edges might show.

Everything else is refinement: which incision, which implant shape, whether to add a small screw. The operation is typically done under general anesthesia or under intravenous sedation with local anesthetic, and most people go home the same day, a pattern the NHS describes for many facial cosmetic operations. Operating time is usually measured in an hour or two rather than a whole afternoon, though this varies with whether other procedures are combined.

The point worth holding onto is that this is real surgery on the face, with real healing, even though the visible evidence afterward is often only swelling.

Through the mouth or through the lower eyelid: how the incision is chosen

Two doors lead to the cheekbone, and each has a personality.

The intraoral route uses a short incision high inside the mouth, in the groove where the upper lip meets the gum above the canine or molar teeth. From there the surgeon tunnels upward and outward to the bone. There is no skin scar at all. The trade-off is that the mouth is not a sterile place, so the incision passes through an environment full of bacteria, and the surgeon must work upward toward the eye socket from below, judging position partly by feel.

The lower eyelid route enters either just beneath the lash line (a subciliary incision) or through the pink inner lining of the eyelid (a transconjunctival incision, which leaves no external mark). This approach gives a direct, top-down view of the upper cheekbone and the rim of the eye socket. It is often preferred when the implant needs to sit high and lateral, or when eyelid surgery is being done anyway. The trade-off is proximity to the eyelid itself, which is delicate and can be pulled downward by scarring.

Feature	Inside the mouth	Lower eyelid
Visible scar	None	None (transconjunctival) or fine line under lashes
View of bone	Indirect, from below	Direct, from above
Best suited to	Mid-cheek and submalar positions	High malar and orbital rim positions
Characteristic concern	Oral bacteria, saliva exposure	Eyelid retraction or ectropion
Often combined with	Chin or jaw implants	Lower eyelid surgery, mid-face lift

Neither route is universally superior. Surgeons choose based on where the implant must sit, what other procedures are planned, and their own experience. Asking why a particular route is being proposed for your face is a fair question, and a good surgeon will have a specific answer.

Step by step: what happens in the operating room

Once you are asleep or comfortably sedated, the sequence is orderly and, to a surgeon, almost routine.

The face is cleaned with antiseptic. If the mouth is the route, it is rinsed with an antimicrobial solution as well. Many surgeons give an antibiotic through the intravenous line before the first incision, a standard practice for operations where a foreign material will be left in the body; the decision and choice rest with the surgical team.

Local anesthetic with a small amount of adrenaline is injected along the planned path. The adrenaline shrinks blood vessels, so the field stays clear and there is less bruising afterward.

The incision is made, typically a centimeter or two long. Using blunt instruments called periosteal elevators, the surgeon lifts the periosteum off the cheekbone and develops the pocket. This part matters enormously. Too small a pocket and the implant buckles or sits crooked; too large and it can migrate before scar tissue anchors it. Surgeons often make the pocket only fractionally bigger than the implant itself.

A sizer or the implant itself is slid in and checked. The surgeon looks at the face from the foot of the table, comparing the two sides, sometimes sitting the patient partway up to see how gravity settles the tissue. Adjustments are made by trimming the implant edges with a scalpel, since most materials can be carved to feather into the bone.

Once satisfied, the surgeon may secure the implant with a small titanium screw or a suture through the periosteum. Some rely on the tightness of the pocket alone. The incision is closed with dissolving stitches inside the mouth, or very fine stitches at the eyelid. A light dressing or tape may be applied over the cheeks to discourage movement while the pocket seals.

You wake in recovery, usually within the hour, with the sensation of a heavy, numb mid-face and very little to see yet.

Malar vs submalar implants: where the implant sits changes the result

People tend to picture one kind of cheek implant. Surgeons work with at least three positions, and the difference explains why two patients can have the same operation and look nothing alike afterward.

A malar implant sits directly over the cheekbone itself, at the highest point of the arch. It adds projection outward and slightly upward, creating the sculpted, angular contour associated with strong cheekbones. This is often chosen for people whose bone is genuinely underdeveloped.

A submalar implant sits lower, in the hollow beneath the cheekbone where the soft tissue has thinned with age. It does not build bone-like projection; it fills a depression. This is the position more often chosen for the tired, sunken look that arrives in the forties and fifties, because the bone is fine and the problem is the deflated tissue in front of it.

A combined or shell implant covers both zones, adding projection at the top and volume below in a single piece.

Why does this matter to someone reading at home? Because the wrong position is one of the main reasons for dissatisfaction. Placing a malar implant on a face that needed submalar volume produces a hard, unnatural ledge above an unchanged hollow. Placing a submalar implant where bone projection was missing produces fullness without definition.

The eyelid approach naturally favors high malar placement; the intraoral approach reaches the submalar zone more easily. That is part of why the choice of incision and the choice of implant are decided together rather than separately.

During consultation, surgeons often press gently on your face or use imaging to show where volume would be added. The useful question is not “do I want cheek implants” but “which region of my mid-face is actually deficient, and what does the evidence of my own photographs from ten years ago say about it.”

What are cheek implants made of?

Three families of material dominate, and each behaves differently once it is in the body. None is a brand recommendation; these are generic classes.

Solid silicone is a soft, rubbery, non-porous material. Because tissue cannot grow into it, the body walls it off in a thin fibrous capsule. The practical upside is that a silicone implant can be removed relatively cleanly years later if needed, sliding out of its capsule. The downside is that, without fixation, it depends on that capsule and a tight pocket to stay put, and in a minority of cases it can shift.

Porous polyethylene is a firmer plastic riddled with tiny interconnected pores. Blood vessels and fibrous tissue grow into those pores over weeks, which anchors the implant firmly and may reduce late migration. The same integration makes removal harder, since the implant is effectively knitted into surrounding tissue.

Expanded polytetrafluoroethylene, usually shortened to ePTFE, sits between the two: softer than polyethylene, with smaller pores that allow limited tissue ingrowth.

All three are considered biocompatible, meaning they are tolerated without a true allergic rejection. Infection, not rejection, is the way implants fail, because bacteria can colonize any foreign surface and are difficult for the immune system and antibiotics to clear once they form a film on it.

A separate approach avoids preformed implants entirely: custom implants milled from a CT scan of the patient’s own skull, designed to fit the bone precisely. These are used more often for reconstruction after injury or for marked asymmetry.

One material detail rarely mentioned: any solid implant resting on bone exerts steady pressure, and over many years some bone beneath the implant can remodel or thin. This is documented most for chin implants but is discussed for cheek implants too. It is usually of no clinical consequence, but it is one reason surgeons prefer the subperiosteal plane and broad-based, well-fitted shapes that spread pressure evenly.

Who is cheek augmentation usually for, and who is asked to wait?

The cleanest candidates share a structural, not superficial, problem. Their cheekbones are genuinely flat or recessed, or the mid-face has lost so much volume that repeated filler is no longer practical. They are in good general health, do not smoke, and have expectations that fit what a piece of solid material can actually do, which is add contour in one region, not rejuvenate a whole face.

Younger adults with a naturally flat malar region, people with mild asymmetry from growth or old injury, and older adults seeking a permanent alternative to ongoing injections are the groups most often seen. Surgeons also treat people who have lost mid-face volume after significant weight loss.

Several situations usually prompt a pause rather than a booking.

• Active dental infection or gum disease when the intraoral route is planned, since the incision would pass through infected tissue. Dental treatment typically comes first.
• Smoking or nicotine use, which narrows small blood vessels and impairs healing of the pocket lining. Many surgeons ask for a period of complete abstinence before and after surgery.
• Poorly controlled diabetes, bleeding disorders, or medicines that thin the blood, all of which need review with the prescribing clinician; nothing should be stopped without that conversation.
• Recent filler in the same region, because residual product can distort the pocket and complicate judgment of the result.
• Facial skeletons that are still growing. Implants are generally reserved for adults whose bone growth is complete.
• Body dysmorphic disorder or a period of acute life stress. The NHS advises anyone considering cosmetic surgery to take time to reflect and to be wary of pressure to decide quickly.

A thoughtful surgeon spends as much of the consultation asking why you want this as explaining how it is done. Being asked to wait is not a rejection. It is usually the safer half of a two-part answer.

Is cheek implant surgery painful?

The honest answer surprises people: the pain is usually less than the swelling, and the swelling is usually less than the numbness.

During the operation itself you feel nothing. General anesthesia keeps you unconscious; sedation with local anesthetic keeps you drowsy and pain-free. MedlinePlus describes both approaches as standard for outpatient surgery, with the choice depending on the procedure, your health, and your preference discussed with the anesthesia team.

In the first day or two afterward, most people describe a deep, dull ache and a sense of pressure across the mid-face rather than sharp pain. Chewing feels awkward if the incision is in the mouth. Blinking and looking upward may feel tight if the incision is at the eyelid. Surgeons typically manage this with prescribed pain relief for a few days, then over-the-counter options; the specific plan belongs to your prescribing clinician, and anything containing blood-thinning ingredients is usually discussed beforehand.

Numbness is the sensation people are least prepared for. The infraorbital nerve, a sensory nerve that exits the bone just below the eye socket and supplies feeling to the cheek, upper lip and side of the nose, runs straight through the surgical field. Surgeons identify and protect it, but stretching during pocket creation commonly leaves the cheek and upper lip feeling wooden or tingly for weeks. In most people this resolves gradually as the nerve recovers; in a small minority some altered sensation persists.

Pain that increases after the third or fourth day, rather than easing, is not part of the normal pattern. Nor is pain concentrated on one side with new swelling or warmth. Those are reasons to call, covered later in this article.

People who have had wisdom teeth removed often say the intraoral recovery feels comparable in its mouth-related discomfort, with the addition of a heavy face for a week or so.

Cheek implant recovery time: what the first days and weeks usually look like

Recovery unfolds in overlapping phases, and the timeline below reflects typical ranges described in general cosmetic surgery guidance from the NHS and Mayo Clinic. Your team will give you a plan specific to your operation, and that plan takes priority over anything written here.

The first 48 to 72 hours are the swelling peak. The mid-face puffs noticeably, sometimes enough that the eyes look narrower. Cold compresses, sleeping with the head elevated, and avoiding bending or straining all help by reducing blood flow and fluid pooling in the tissues. Bruising, if it appears, tends to track downward toward the jaw over the following days.

Through the first week, if the incision is intraoral, eating is soft and careful: soups, yogurt, mashed food, nothing that requires wide opening or forceful chewing. Gentle rinsing with a prescribed or salt-water mouthwash after every meal keeps the wound clean. If the incision is at the eyelid, the eyes may feel gritty and the lower lid slightly swollen; ointment and gentle cleansing are usually advised.

Most people feel presentable enough to return to desk work, with makeup if desired, somewhere between one and two weeks. Strenuous exercise, anything that raises blood pressure into the face, is usually held for around three to four weeks to protect the healing pocket. Contact sports and activities with any risk of a blow to the face wait longer, often six weeks or more, because an implant can shift before scar tissue has fully fixed it.

By four to six weeks, the gross swelling has largely gone and the shape is recognizable, though the tissue still feels firm and the cheeks slightly larger than the final result.

The last phase is quiet and slow. Residual swelling, firmness and numbness continue to settle over three to six months. Surgeons usually ask you to withhold judgment on symmetry and size until that point, because early results almost always look bigger than the end result.

What are the downsides of getting a cheek implant? Cheek implant risks explained

Every foreign object placed in the body carries a permanent, low-level possibility of trouble, and cheek implants are no exception. The risks are uncommon, but they are real, and a fair explainer states them plainly.

Infection is the most consequential. It can appear in the first weeks or, less often, months to years later, sometimes after a dental procedure or an unrelated illness. Because bacteria form a protective film on implant surfaces, antibiotics alone often cannot clear an established implant infection, and the usual solution is removal, a period of healing, and possible replacement later. Signs to watch for are described in the section on when to call your doctor.

Malposition and asymmetry are the most common reasons for revision. An implant seated a few millimeters too high, too low, or rotated produces a visible difference between the sides that swelling may hide for weeks. Migration, where the implant drifts within a loose pocket, can happen in the early months before fixation by scar.

Nerve injury has already been mentioned: temporary numbness of the cheek and upper lip is common; persistent altered sensation is uncommon but possible. The nerve that lifts the upper lip can rarely be affected, producing a temporarily uneven smile.

The lower eyelid route carries its own signature complication. Ectropion is a condition in which the lower eyelid pulls away from the eye and turns outward, exposing the pink inner surface. Scarring after eyelid incisions can cause this, and it may need further surgery to correct.

Other possibilities include bleeding and hematoma (a collection of blood in the pocket), visible or palpable implant edges in people with thin skin, extrusion (the implant working its way through the incision, usually a consequence of infection), and gradual thinning of the bone beneath the implant over many years.

Finally, there is the possibility of simply not liking the result. Faces are perceived as a whole, and adding volume in one region changes the balance of everything around it. That is not a surgical failure, but it is a downside worth naming.

Cheek implants vs fillers vs fat grafting: how the alternatives compare

Implants are one of three main ways to add mid-face volume, and the right choice depends less on which is “best” and more on what is actually missing and how permanent you want the answer to be.

Injectable fillers, most commonly gels based on hyaluronic acid (a sugar molecule found naturally in skin), are placed with a needle or blunt cannula in a clinic visit, with no incision and no anesthesia beyond numbing cream. They can be adjusted, and hyaluronic acid products can be dissolved with an enzyme if the result is wrong. Their limitation is duration: the body breaks them down over months to a year or two, so maintaining a result means repeating treatment indefinitely. They are also soft, and cannot mimic true bone projection in a very flat cheek.

Fat grafting harvests fat from elsewhere on the body by liposuction, processes it, and injects it into the cheeks. It uses your own tissue, so there is no implant to infect or migrate. Its limitation is unpredictability: a proportion of transferred fat does not survive, the amount varies from person to person, and a second session is sometimes needed. Fat also changes with body weight, so the cheeks can grow or shrink with the rest of you.

Implants offer a single, permanent, structural correction with the most definition, at the price of a real operation, a foreign body for life, and the risks described above.

A mid-face lift, which repositions sagging soft tissue upward over the bone, is a fourth option for people whose problem is descent rather than deficiency. Some surgeons combine it with implants.

Doing nothing is a legitimate alternative, and a good consultation will say so. None of these paths is better than another in the abstract. They answer different questions, and the surgeon’s job is to work out which question your face is asking.

Do cheek implants last forever? Longevity, removal and revision

The materials used for cheek implants do not degrade or wear out in the body in any meaningful timeframe. In that narrow sense, they are permanent. But “the implant lasts” and “the result lasts unchanged” are different claims, and only the first is reliably true.

The face keeps aging around the implant. Skin thins, fat continues to diminish, and soft tissue continues to descend. An implant that looked perfectly integrated at forty-five may look more prominent at sixty-five, as the cushion over it thins, or may look less effective as the tissue below it sags further. Some people eventually have the implant exchanged for a different size or position; some have it removed and switch to another approach.

Removal is generally possible with any material, though the ease varies. Silicone implants sit in a capsule and usually slide out through the original incision. Porous materials with tissue ingrowth require the surgeon to cut the implant free from surrounding fibrous tissue, which is more involved but routinely done. After removal, the pocket collapses and the overlying tissue usually settles back over weeks, though it may not return exactly to its pre-surgery contour, particularly if the implant was large or in place for many years.

Revision rates for facial implants are not reported with the consistency that would allow a single trustworthy figure here, and this article will not invent one. The honest summary from the surgical literature is that most people do not need further surgery, that a meaningful minority do, and that the commonest reasons are asymmetry, malposition and infection rather than material failure.

Two practical implications follow. First, keep a record of what was placed: material, size, shape and manufacturer, along with the operative note. Future clinicians, including dentists and radiologists, will want it. Second, mention the implant before any dental work or facial procedure, so that infection precautions can be considered by the treating team.

What people often get wrong about cheek implants

Misconceptions cluster around this operation, partly because it is less discussed than rhinoplasty or facelifts and partly because the word “implant” carries baggage from other parts of the body.

“They will be rejected like a transplanted organ.” They will not. Rejection is an immune response to foreign living tissue. Silicone, polyethylene and ePTFE are inert; the body walls them off or grows into them. What can happen is infection, which is a different process with a different solution.

“Implants make everyone look the same.” The overfilled, uniform look people worry about is far more often the product of repeated large-volume filler than of a well-fitted implant. An implant sized to the bone and placed subperiosteally lifts the tissue from beneath rather than inflating it.

“There will be a scar on my face.” Neither standard route leaves a visible facial scar. The intraoral incision heals inside the mouth; the transconjunctival incision heals inside the eyelid. A subciliary incision leaves a fine line hidden by the lashes.

“Once it is in, it can never come out.” Removal is a recognized, routine procedure. It is more involved with porous materials, but it is done.

“If it looks too big at two weeks, it is too big.” Swelling at two weeks routinely adds visible bulk on top of the implant. Surgeons ask for months, not weeks, before judging size, because early revision on a swollen face is a reliable way to end up with an under-corrected result.

“It is a small procedure.” Small incision, yes. Small procedure, no. It involves general anesthesia or deep sedation, dissection on bone next to the eye and a major sensory nerve, and a foreign body for life. Treating it with the seriousness of any operation, including choosing a surgeon with recognized specialist training and hospital-standard facilities, is the single most protective decision you make.

How to prepare for a cheek implant surgery procedure

Preparation for this operation is mostly about two things: making the mouth or eyelid as clean and healthy as possible, and making the days afterward easy on yourself.

If the intraoral route is planned, a dental check beforehand is worthwhile. Gum inflammation, decayed teeth or an untreated abscess near the incision site raise the bacterial load exactly where the surgeon will be working. Many surgeons want dental issues addressed first. Good brushing and flossing in the weeks before surgery is not vanity; it is infection control.

Nicotine in any form, including vaping and patches, constricts the tiny vessels that must heal the pocket lining. Surgeons commonly ask for complete abstinence for a period before and after surgery, and are increasingly willing to postpone if that is not achieved.

Bring a complete list of medicines and supplements to your pre-operative assessment. Some over-the-counter products, herbal preparations and prescription drugs affect bleeding or interact with anesthesia. Do not stop anything on your own; the surgical and prescribing teams will tell you what to pause and when.

Mayo Clinic’s general guidance on preparing for cosmetic surgery emphasizes arranging practical support: someone to drive you home, since you cannot after anesthesia, and ideally to stay the first night. Stock soft foods and a gentle mouth rinse if the mouth is the route. Set up extra pillows to sleep propped up. Plan for one to two weeks away from public-facing work if appearance matters in your role.

Take photographs of your face from several angles before surgery. They are your own record, useful for judging the result honestly months later, and for any future consultation.

Finally, the NHS advises using the time before any cosmetic operation to reflect, to ask every question you have, and to feel free to change your mind. A surgeon who welcomes that is showing you something about how they will handle complications too.

Questions to ask your care team

A consultation is a conversation, not a sales appointment. These questions help you understand what is being proposed and why, and they signal to the surgeon that you have done your homework.

• Which region of my mid-face do you consider deficient, and how did you decide between malar, submalar and combined placement?
• Which incision are you planning for me, mouth or lower eyelid, and what specifically about my anatomy or goals drove that choice?
• What material and shape of implant do you intend to use, and why that one for my face?
• Will the implant be fixed with a screw or suture, or held by the pocket alone, and what is your reasoning?
• What type of anesthesia will I have, and who will be delivering it?
• How do you protect the infraorbital nerve during dissection, and how often do your patients report lasting numbness?
• If the eyelid route is used, what is your approach to preventing lower eyelid retraction?
• What is your plan if the implant becomes infected, and what does that process involve for me?
• How long do you ask people to wait before judging the result, and what is your policy on revision if there is asymmetry?
• Would filler or fat grafting be reasonable alternatives for me, and what would you expect the trade-offs to be?
• What is your specialist training and registration in facial or plastic surgery, and where will the operation take place?
• Who do I call, at any hour, if something worries me in the first two weeks?
• May I see before-and-after photographs of patients with anatomy similar to mine, including any who needed revision?

Notice what is missing: nothing about cost. That conversation matters, but it belongs with the administrative team and should never be the deciding factor in whether a foreign body is placed against your facial bone. The clinical answers above are what determine whether this operation is right for you, and the decision, at every stage, rests with you and your treating team together.

When to call your doctor

Most recoveries are uneventful, and most of what you notice in the first two weeks, swelling, bruising, numbness, tightness, a heavy sensation, is expected. But a short list of signs should prompt a call to your surgical team the same day, and a shorter list should send you to emergency care without waiting.

Call your surgeon promptly if you notice:

• Pain that increases after the first three to four days instead of easing, especially if it is concentrated on one side.
• New or worsening swelling, warmth or redness over one cheek, or a spreading area of red skin. MedlinePlus lists these as typical signs of a surgical wound infection.
• Fluid, pus or a bad taste draining from the incision inside the mouth, or discharge from the eyelid incision.
• Fever or chills.
• A feeling that the implant has moved, or a visible change in cheek position after a knock or sneeze.
• The lower eyelid pulling away from the eye, persistent watering, or difficulty closing the eye fully.
• Numbness that is spreading rather than shrinking after the first few weeks, or a new weakness in your smile.

Seek emergency care immediately if you experience sudden severe swelling of one side of the face with a feeling of tightness, which can signal bleeding into the pocket; any change in vision, severe eye pain or a bulging eye; difficulty breathing or swallowing; chest pain, breathlessness, or a painful swollen calf, which can indicate a blood clot after any operation; or heavy bleeding that does not stop with gentle pressure.

Late problems also count. Months or years after surgery, a cheek that becomes painful, swollen or red, particularly after dental work or an illness, should be assessed by a clinician who knows an implant is present. Late infection is uncommon, but it is treatable, and the outcome is better when it is caught early.

None of these signs means something has definitely gone wrong. They mean someone with training should look. Your surgical team expects these calls, and would far rather hear from you unnecessarily than not at all.

Frequently asked questions

What are the downsides of getting a cheek implant?

The main downsides are infection, which may require removing the implant; asymmetry or malposition needing revision; temporary and occasionally lasting numbness of the cheek and upper lip; and, with the lower eyelid route, the risk of the eyelid pulling downward. Implants also add a permanent foreign body that must be declared before future dental or facial procedures, and the face continues to age around them, so the result can change over decades.

Is cheek implant surgery painful?

Most people describe a deep ache and pressure across the mid-face for a few days rather than sharp pain, usually managed with prescribed pain relief chosen by the surgical team. The more noticeable sensations are swelling, tightness and numbness, which can last weeks. Pain that worsens after the third or fourth day, or is concentrated on one side with warmth or redness, is not typical and should be reported.

What is the average cost of cheek implants?

This article does not give prices. Fees vary widely with the surgeon’s training, the anesthesia used, the facility, the implant material, whether other procedures are combined, and whether revision is ever needed, so a single figure would mislead more than inform. Ask the practice’s administrative team for a full written breakdown, and keep the clinical decision, whether this operation is right for you, separate from the financial one.

How long does it take to recover from cheekbone implant surgery?

Swelling peaks in the first two to three days and most people feel presentable for desk work within one to two weeks, based on general cosmetic surgery timelines described by the NHS and Mayo Clinic. Strenuous exercise usually waits three to four weeks and contact activities longer. Residual firmness, mild swelling and numbness commonly continue settling for three to six months, which is when surgeons suggest judging the final contour.

What is the difference between malar and submalar implants?

A malar implant sits directly over the cheekbone and adds outward projection, creating a more angular, defined cheek. A submalar implant sits lower, in the hollow beneath the bone, and restores volume lost to aging or weight loss without adding bony definition. Combined implants cover both zones. Which region is actually deficient in your face determines the choice, and often the incision route as well.

Can cheek implants be removed later?

Yes. Removal is a recognized procedure with any material. Solid silicone implants sit in a fibrous capsule and usually slide out through the original incision. Porous polyethylene and ePTFE implants have tissue growing into them, so the surgeon must free them from surrounding tissue, which is more involved but routine. After removal the tissue generally settles back over weeks, though not always to exactly the pre-surgery contour.

Do cheek implants leave a visible scar?

Neither standard route leaves a scar on the skin of the cheek. The intraoral incision heals inside the mouth above the upper gum. The transconjunctival incision heals on the inner lining of the lower eyelid. If a subciliary incision is used, it leaves a very fine line just beneath the lower lashes that typically fades into the natural crease. Scars from revision or infection-related surgery follow the same hidden routes.

Are cheek implants done under general anesthesia?

Usually either general anesthesia or intravenous sedation combined with local anesthetic, according to standard descriptions of outpatient facial surgery. The choice depends on the extent of surgery, whether other procedures are combined, your health history and your preference, and is made with the anesthesia team. Either way you should feel nothing during the operation, and most people return home the same day with an adult to accompany them.

Is filler or a cheek implant better for flat cheeks?

Neither is better in the abstract; they suit different problems. Hyaluronic acid filler is adjustable and reversible but temporary, needing repeat treatment, and cannot mimic true bone projection. An implant gives a permanent structural correction with more definition but involves surgery and a lifelong foreign body. Fat grafting uses your own tissue with less predictable retention. A surgeon assessing your bone and soft tissue can explain which fits your anatomy.

What are the cheek implant risks specific to the lower eyelid approach?

The signature risk is ectropion or lid retraction, where scarring pulls the lower eyelid downward and away from the eye, causing exposure, watering or an altered eye shape. It may need further surgery. The eyelid route also involves working close to the eye itself, so bleeding behind the eye, though rare, is treated as an emergency. Surgeons choose this route when the direct view of the high cheekbone outweighs these concerns.

References

• NHS: Cosmetic procedures
• MedlinePlus: Plastic and Cosmetic Surgery
• MedlinePlus: Surgical wound infection, treatment
• MedlinePlus: Anesthesia

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.