Even if there is nothing wrong with the implants―they haven’t drifted, caused complications, or caused pain―if you are unhappy with your appearance, that is reason enough to seek an adjustment. A surgeon who doesn’t listen to your concerns about your appearance can be incredibly frustrating. If your original surgeon isn’t listening to your concerns, it’s time to find a doctor who will!
Removing old implants
Since the 1990s, implants have evolved to a more anatomic shape. Most implant-related issues are the result of oversized implants or implants that have settled in less than ideal fashion. Ill-fitting implants may require surgical removal, replacement, or both. Implant placement can be associated with motor nerve damage to the muscles of facial expression or can compromise the appearance of the lower eyelid. Sometimes post-surgical changes associated eyelid surgery may need to be revised at the same time the cheek implant is removed. As many of these situations have unique characteristics, Dr. Steinsapir prefers hand-carving a custom ePTFE implant to replace the old implant.
Revising the Submalar Implant
A submalar implant, which sits low on the cheek is a newer type of cheek implant. While this submalar volume positioned at a low level may have appeared complementary at the time of the surgery, some find that this implant begins to look objectionable as the face ages. Occasionally this problem is made worse because the original surgeon chose the wrong size of implant, or because the implant may not have settled correctly after surgery. In these circumstances, the best approach is to remove the original implant, and then replace the volume deficiency with a hand-carved custom orbital rim implant in conjunction with a vertical midface lift.
Other methods have also been described to address midface deficits. Cheek implants represent a classic approach to midface deficiencies. The implant is notched to accommodate the inferior orbital neurovascular bundle. More recently, a porous polyethylene implant has been introduced on the market to accomplish the same augmentation. However, these techniques provided only a modest improvement in the nasojugal groove and importantly it removes volume from the lower eyelid.
Choosing a physician
Because your current surgeon is not addressing your discontent to your satisfaction, it may be best for you to find a new surgeon to perform the adjustments to your cheek implants. When looking for a physician, make sure to choose someone who listens to your concerns and someone who is willing to work with you to find a solution that works with your face, your situation, and helps you to find a satisfactory conclusion.
About Dr. Steinsapir
Dr. Steinsapir is a much sought after oculofacial cosmetic surgeon. He is an innovator in minimally invasive cosmetic procedures and has invented new methods for treating with BOTOX, Fillers and cutting edge facial surgery. He specializes in high precision eyelid surgery and is a leader in correcting prior facial and eyelid surgery. He attended medical school at the UCLA and completed ophthalmology residency at The University of Chicago. He is multiple fellowship trained including three years of fellowship training in oculofacial plastic surgery at UCLA, and a two year cosmetic surgery fellowship in Rancho Mirage. He is widely published and lectures to other surgeons nationally and internationally. He is an associate clinical professor of Ophthalmic Plastic and Reconstructive Surgery at the Jules Stein Eye Institute at UCLA. His private practice is located in West Los Angeles, immediately serving the Los Angeles and Beverly Hills communities. Additionally, individuals from all over the country and the world regularly come to Los Angeles for this expert care Please contact us today to learn more about how Dr. Steinsapir can help you attain your aesthetic goals.
Facial filler treatments and fat grafting can be excellent ways to soften the facial features by correcting imbalances and deficiencies in facial fat distribution. Your decision to pursue fat grafting treatment is one you should carefully consider with your doctor, as there are multiple options for achieving your desired look, and the solution that’s best for you will depend on variables like your medical history, present condition, and treatment goals. Like other treatment options available today, fat grafting is particularly suited for some individual’s needs, while for others there may be other more suitable options.
Fat Grafts and Changes in Weight
If your weight changes just a little, you probably won’t notice much difference in your treatment results. If you have significant changes in weight, though, you could see some differences in the form of increased facial volume. This is important to consider before opting for fat grafts. While you probably aren’t planning on gaining weight, you and your doctor should take into account the likelihood of weight fluctuations given your medical history and current lifestyle.
So what can you expect with changes in weight? This depends on the individual, but with small changes in weight there is generally little change in the fat graft volume. However, with an increased weight and body fat, the grafts also increase in volume like the fat compartment from which they were removed. For example, when the body fat increases 10% or more, the grafted fat also significantly increases in volume.
While the effects of most facial cosmetic surgery eventually diminish over time, it’s important to recognize that fat grafting does yield long-term results. This is a great benefit for those who seek long-term change, but there are also times when the nature of this treatment can result in an unsatisfactory result even years after the original fat grafting procedure.
Achieving the Best Long-Term Results
In an ideal world we will all of course adopt a healthy, active lifestyle that includes good nutrition and keeps your weight at a stable place where your body works best. But the reality is that most Americans gain about one pound of weight per year. While most qualified cosmetic surgeons can comfortably adjust and even reverse treatments with Restylane and other hyaluronic acid fillers, correcting the facial contour after fat grafting is not so simple or straightforward.
These tendencies lead many cosmetic surgeons to favor the new facial fillers—like undereye Restylane, Perlane, and Juvederm—for most patients. These fillers do not last as long as fat grafts, but they are very popular and effective because they are safe, provide benefit without the necessity of surgery, can be adjusted with the enzyme hyaluronidase, and have science-based, proven results.
Does this mean that fat grafting is wrong for you? Not necessarily—fat grafting is an excellent option for certain situations on a person-to-person basis, just as facial fillers and other procedures like the facelift work well for many individuals. You will need to consult with an experienced cosmetic surgeon before making a final decision that is right for you.
Experience Counts; Consult with the Best
Dr. Steinsapir is a leader in cosmetic facial fillers and other cosmetic facial treatments and surgeries. In fact, he has served as a physician consultant to Medicis, Inc. (Perlane’s and Restylane’s distributor). He has developed Deepfill Restylane, the world-renowned method of treating dark circles under the eyes. His practice emphasizes minimally invasive treatment methods that are customized for the individual’s unique situational needs, with the aim of fast healing time and natural results. For more information on how Dr. Steinsapir can help you determine your best treatment options, contact us today.