Modern Facial Implants

Facial implants are the latest, newest, and most exciting rage in cosmetic surgery.  They are truly the wave of the future.  The technology and refinement of facial implant surgery has occurred only since the 1980s and mostly through the innovative creation by facial contouring pioneer Dr. Edward Terino of a large variety of sizes and shapes of facial implants with unique anatomic designs which fit securely on the facial bones, look natural and normal, and feel like the patient’s own underlying bone structure. 

This new and exciting technology is minimally invasive by using small openings under the chin, inside the mouth, and the corner of the eyes to place the implants on the cheeks, under the eyes, in the chin, and along the entire jaw including the angles at the back of the jaw line.  They are short operations of 30-60 minutes requiring only light anesthesia and have minimal to no pain.  Any pain is usually easily tolerated by the patient and is very short lived.

Of course, no operation can be performed without considerable initial swelling.  In the face, the swelling from any operative procedure persists longer in the cheek region and in the jaw region.  Chin implant operations look relatively normal and natural after only 2-4 weeks.  The cheeks and the jaw line swelling often last several months until the best appearance is achieved. But, even after just a few weeks, their appearance is perfectly satisfactory for the patient to appear in public and have their surgery not be noticed.

The shape and form and contours of a face determine aesthetic beauty.  The three areas in order of importance are:  1) The cheeks and midface;  2) The chin and jaw line in the lower third of the face;  3) The nose prominence.  When one of these is excessively large, the other two look smaller.  When two are excessively large, the third one will be out of balance.  When one or more of these areas is excessively small, the third area will look excessively large and out of balance.  These are the principles of facial harmony and aesthetic beauty which must be known by all plastic surgeons who decide to add facial implant contouring to their full complement of surgeries offered in their practices.

Facial contouring by facial implants is the most challenging and artistic form of facial aesthetic surgery.  Cosmetic surgery changes of the face are mostly requested for aging changes of loosening and sagging in and around the forehead, the eyebrows and temple, the upper and lower eyelids, the sagging smile lines around the mouth, and the loosening and sagging of the jowls in the lower face and central neck. 

The majority of the cosmetic facial surgeries developed since the 1970s have addressed issues of lifting, tightening and removing excess tissues when it comes to skin, muscles, and fat.  These procedures all are two‑dimensional in nature and basically produce more flattening of the surface of the face and neck. In some places, such as the neck, this flattening will look better, but in other places on the side of the face, it may look definitely artificially tight and wind blown.  The only cosmetic procedure, which has three-dimensionality, other than facial implant surgery, is a rhinoplasty, or nose operation, in which the size and shape of the nose is altered and reduced.

Otherwise, facial contouring by implants is truly a three-dimensional sculpturing of the face.  The term facial contouring, therefore, can only be realistically applied to procedures which significantly alter the three-dimensional sculptural qualities of the face which artists have painted and sculpted for centuries.

All other lifting and tightening face procedures cannot be termed contouring since they are performed in a linear, horizontal, and uniplanar fashion. 

The facial contouring surgeon who uses implants must understand the great variation in size and shape of the various anatomic parts of the face which take up volume and have mass and form.  Then, he must be able to translate the patient’s concerns of how they feel and look about certain structural areas from his own personal knowledge and experience. This knowledge must include what implants are available, and how and where to use them.  The size, the shape, and the positioning of the implants in the face have very different appearances even if they are only a 1/16^th or 1/8^th of an inch different in size, shape, and position.  As mentioned above, the procedures themselves are minimally invasive, minimally painful, and quickly performed.

Finally, facial implant changes to the contours of the face create facial balance of the major areas of volume and mass in the cheeks and midface, the chin, jaw and lower face, and the nose.  The changes which they produce are timeless and life lasting.  The beauty of silicone rubber implants, however, makes them relatively easy to change and alter if necessary.  Moreover, the implant contour changes are totally reversible. Easy removal of the implants can be done and the overlying skin and soft tissues return in almost all instances to their original preoperative appearance unless aging changes have occurred if the implant surgery was done many, many years ago.  All other forms of facial surgery rely on lifting and stretching the elastic tissues of the skin, the muscles, and the tendinous tissue planes. Lifting and stretching changes are short lived and will always gradually stretch again, even though they may last up to 10 years or 20 years. It is not unusual for two-dimensional facial soft tissue operations such as neck and face lifting to need revision and secondary tightening 2 or 3 times in a person’s life if they start sometime in their late 40s or early 50s, especially now that individuals are customarily living well into their 80s.

The addition of three-dimensional contours by the addition of permanent form stable facial implants to other aesthetic face procedures is not only complimentary, but also adds the illusion of a longer lasting result to the traditional two-dimensional flat, planar lifting and tightening procedures.

This makes facial implant contouring procedures highly desirable and state of the art for cosmetic facial surgery.

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