Sarah Lewis, PharmD
What is a facial implant?
A facial implant is surgery to enhance or balance the appearance of your face using sculpted prostheses. Most people have a facial implant for cosmetic reasons. It can correct uneven facial features or it can create a more youthful look. Facial implants are sometimes medically necessary to reconstruct facial features.
A facial implant is a major surgery with risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having a facial implant.
Types of facial implants
Facial implants commonly consist of silicone that your doctor forms to your specific needs. Other substances include synthetic polymers and composites. Some implants are designed to allow your own tissues to grow into the implant.
The types of facial implants include:
Cheek implants increase the projection of the cheekbones.
Chin implants increase the size or projection of the chin.
Forehead implants lift the forehead skin to create a more youthful appearance.
Jaw implants increase the width of the lower face.
Nose implants increase the projection of the nose tip or widen the nose bridge.
Other procedures that may be performed
Looking for a Doctor?
Your doctor may perform other procedures to complement a facial implant. These include:
Brow lift, or forehead lift, is the surgical lifting and smoothing of the forehead.
Eyelid surgery, or blepharoplasty, is the surgical removal of excess skin, muscle and fat in the upper or lower eyelids.
Facelift is the surgical correction and improvement of the signs of aging on the face and neck.
Nose surgery, or rhinoplasty, is the surgical repair or reshaping of the nose.
Why is a facial implant performed?
Your doctor may recommend a facial implant if you want to improve the look of your face for cosmetic reasons. Your doctor may also recommend it to reconstruct facial features.
Your doctor will only consider a facial implant if other options with less risk of complications are not appropriate for you or have not worked. You should also be physically healthy, not smoke, and have realistic expectations of improvement, not perfection.
Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on a facial implant.
Your doctor may recommend a facial implant if:
Your facial features are unbalanced or disproportionate.
Your facial features require reconstruction due to trauma, disease, or birth defects.
Your cheeks are sunken or flat.
Your chin is recessed, lacking distinction from your neck.
Your jaw is not distinct from your neck, leading to sloping from your ears to your chin.
Your forehead is sloping or misshapen.
Your nose is flat across the bridge or at the tip.
You want a more youthful look to your face.
Who performs a facial implant?
The following specialists perform facial implants:
Plastic surgeons specialize in aesthetic and reconstructive surgery.
Facial plastic and reconstructive surgeons specialize in plastic and reconstructive surgery of the face. They initially train as plastic surgeons or otolaryngologists (ear, nose and throat doctors/surgeons).
Head and neck plastic surgeons specialize in plastic and reconstructive surgery of the head and neck. They also train as plastic surgeons or otolaryngologists (ear, nose and throat doctors/surgeons) before further specialization.
How is a facial implant performed?
Your facial implant will be performed in a hospital or outpatient setting using one of the following approaches:
Chin implant requires an incision inside your mouth in the crease between your lower lip and your lower gum. An alternate approach is an incision underneath your chin.
Cheek implant requires an incision inside your mouth in the crease between your cheek and your upper gum. Alternate approaches include an incision inside your lower eyelid or an incision in your hairline.
Forehead implant requires an incision in your hairline.
Jaw implant requires an incision inside your mouth in the crease between your cheek and your lower gum.
Nose implant requires either a minimally invasive incision inside your nostrils or an open incision in the columella, the strip of tissue between the nostrils and above the upper lip.
A facial implant is usually an outpatient procedure. Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital based on your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different facial implant procedures and ask why your doctor will use a particular type for you.
Types of anesthesia that may be used
Your doctor will perform your facial implant using either general anesthesia or local anesthesia, depending on the specific procedure.
General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain.
Local anesthesia with sedation involves injections of a local anesthetic into the skin of the surgical area. You will be awake, but will not feel pain during the procedure. You will also have a sedative to help you stay relaxed and comfortable.
What to expect the day of your facial implant
The day of your surgery, you can expect to:
Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.
Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.
Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will receive.
A surgical team member will start an IV.
The anesthesiologist or nurse anesthetist will start your anesthesia.
A tube will be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.
The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.
What are the risks and potential complications of a facial implant?
As with all surgeries, a facial implant involves risks and possible complications. Most facial implants are successful, but complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.
General risks of surgery
The general risks of surgery include:
Anesthesia reaction, such as an allergic reaction and problems with breathing
Bleeding, which can lead to shock
Blood clot, in particular a deep vein thrombosis that develops in the leg or pelvis. A blood clot can travel to your lungs, heart or brain and cause a pulmonary embolism, heart attack, or stroke.
Infection and septicemia, which is the spread of a local infection to the blood
Potential complications of a facial implant
Complications of a facial implant include:
Changes in sensation or numbness
Damage to nerves, blood vessels, muscles, gums or teeth
Poor wound healing
Shifting of the implant, possibly requiring another procedure to reposition it
Uneven contours or firmness around the implant
Asymmetry of your face
Reducing your risk of complications
You can reduce the risk of certain complications by following your treatment plan and:
Following activity, dietary, oral care, and lifestyle restrictions and recommendations before your procedure and during recovery
Informing your doctor if you are nursing or if there is any possibility that you may be pregnant
Not smoking. Smoking impairs wound healing
Notifying your doctor immediately of any concerns, such as bleeding, fever, or increase in pain
Taking your medications exactly as directed
Telling all members of your care team if you have any allergies
How do I prepare for my facial implant?
You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome.
You can prepare for a facial implant by:
Answering all questions about your medical history, allergies, and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a chest X-ray, facial X-ray, EKG (electrocardiogram), blood tests, and other tests as needed.
Losing excess weight before the surgery through a healthy diet and exercise plan
Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.
Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.
Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your doctor will give you instructions for taking your specific medications and supplements.
Questions to ask your doctor
Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before a facial implant and between appointments.
It is also a good idea to bring a list of questions to your appointments. Questions can include:
Am I a good candidate for a facial implant? Are there any other options for improving the appearance of my face?
What type of facial implant procedure do I need?
How long will the surgery take? When can I go home?
What restrictions will I have after the procedure? When can I return to work and other activities?
How should I care for my incisions? How should I care for my teeth and gums during recovery?
Will I have dietary restrictions?
What kind of assistance will I need at home?
How should I take my medications?
How will you treat my pain?
When should I follow up with you?
How should I contact you? Ask for numbers to call during and after regular hours.
What can I expect after my facial implant?
Knowing what to expect after a facial implant can help make your road to recovery as smooth as possible.
How long will it take to recover?
You will stay in the recovery room after surgery until you are alert, breathing effectively, and your vital signs are stable. You may have a sore throat if a tube was placed in your windpipe during surgery. This is usually temporary, but tell your care team if you are uncomfortable.
Facial implants are usually outpatient procedures. You will still be drowsy from sedation or anesthesia, so you will need a friend or family member to drive you home and stay with you the first night.
You may or may not have a dressing on your incision, depending on its location. You will likely have swelling, discomfort and bruising following a facial implant. Your doctor will treat your pain. Bruising and swelling should subside within a few weeks. You may need to wear a brace while sleeping for a few weeks.
Recovery after a facial implant is a gradual process. Recovery time varies depending on the procedure, your general health, age, and other factors. Most people return to normal activities within a week, but need to avoid strenuous activity for four to six weeks. Full recovery and maximal facial improvement takes three to four months.
Will I feel pain?
Pain control is important for healing and a smooth recovery. You will be sore after your surgery. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes in any way because it may be a sign of a complication.
When should I call my doctor?
It is important to keep your follow-up appointments after a facial implant. Contact your doctor for questions and concerns between appointments. Call your doctor right away or seek immediate medical care if you have:
Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing
Change in alertness, such as passing out, unresponsiveness, or confusion
Chest pain, chest tightness, chest pressure, or palpitations
Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after surgery. It is not necessarily a sign of a surgical infection. However, you should follow your doctor's specific instructions about when to call for a fever.
Inability to urinate or have a bowel movement
Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot
Pain that is not controlled by your pain medication
Uncontrolled or heavy bleeding
Unexpected drainage, pus, redness or swelling of your incision
How might a facial implant affect my everyday life?
The new appearance of your face may improve your satisfaction with how you look and increase your self-confidence. However, many surgeons caution that it is important to be realistic about how much a facial implant may improve your self-image. Talk to your surgeon about what a facial implant can and cannot do for your overall appearance.
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- Facial Implants. American Society for Aesthetic Plastic Surgery. http://www.surgery.org/consumers/procedures/head/facial-implants.
- Facial Implants. American Society of Ophthalmic Plastic and Reconstructive Surgery. http://www.asoprs.org/i4a/pages/index.cfm?pageid=3656.
- Facial Implants. American Society of Plastic Surgeons. http://www.plasticsurgery.org/Cosmetic-Procedures/Facial-Implants.html.
- Facial Implants. Cleveland Clinic. http://my.clevelandclinic.org/services/cosmetic_surgery/hic_facial_implants.aspx.
- Pile, JC. Evaluating postoperative fever: A focused approach. Cleveland Clinic Journal of Medicine. 2006;73 (Suppl 1):S62. http://ccjm.org/content/73/Suppl_1/S62.full.pdf.