FACIAL IMPLANTS - QUESTIONS AND ANSWERS
Because informed patients are so important to the success of any
plastic surgery, Dr. Robert H. Stubbs,
a Canadian and American Board Certified Plastic Surgeon has prepared this
web info for you. The web info will give you a basic understanding of the
procedure - when it can help, how it is performed and what results you
can expect. It can not answer all your questions, since a lot depends on
the individual patient and the surgeon. Please ask a certified Plastic
Surgeon about anything you do not understand.
A: Facial implants are man-made (synthetic) substitutes for your own body tissues. They are most often used to enhance the nose, cheeks or chin regions. Your own tissues (for example rib bone or cartilage) may be used for the same purpose, but the risks and costs are usually much greater.
Your face, more than any other part of your body, is what defines you. You use it to communicate, to be recognized, and to influence other people. Yet, at its most fundamental level, your face is a composite of structural elements - chin, cheeks, nose, brow, jaw seen in the context of your whole face. It is the relationship between these structural elements that creates the look that is uniquely yours.
When one of these elements is too big, too small, too prominent, it tends to throw the face out of balance. Facial contouring, using carefully styled implants, can create a more attractive, harmonious balance among your facial features. Implants can be used alone or in conjunction with other facial procedures (such as combining chin augmentation with a facelift to enhance the chin/neck angle).
A: Facial surgery can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations - they must be realistic.
The best candidates for implants are people looking for improvement, not perfection, in the way they look. You should be physically healthy, psychologically stable, and realistic in your expectations. Patients considering a facial implant should be aware of alternative surgery (such as breaking and advancing the lower jaw instead of a chin implant) and be aware that no man-made substance is perfect. Some patients will not tolerate even the most inert (minimally reactive) substance and for these patients using their own tissues is the best option.
A: All surgery carries some uncertainty and risk. Facial surgery is normally safe, as long as patients are carefully selected, the operating facility is properly equipped and the physician is a certified Plastic Surgeon.
A facial implant will occasionally shift in position after the operation. It does not happen often, but if the implant shifts, the only way to correct it is to redo the operation. A small percentage of patients develop an infection around the implant. While this may occur at any time, it is most often seen within a few weeks after surgery. In some cases, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted. Occasionally, some patients will experience minor injury or bruising to the facial nerves which provide feeling and movement to the lip and chin areas. This condition is usually temporary.
You may have concerns about the use of an implant made of silicone. Facial implants, unlike breast gel implants, are made of solid silicone. They have a long and safe history for human implantation.
A: In your initial consultation, we evaluate your health, determine what you want and assess your facial balance. Alternative facial-contouring methods that may be appropriate - such as autografting (your own tissue) are reviewed.
Be honest in discussing your expectations. We will be frank with you, describing the procedure in detail and explaining its risks and limitations. We will also explain the anesthesia used, the location where surgery will be performed and the total costs involved. During this consultation, be sure to tell us about any medications (especially aspirin or other pills that affect clotting), vitamins or other drugs you are taking. Smokers should consider giving up the habit before and after surgery. Then, a complete physical along with blood and urine analysis is arranged.
A: The patient should not have had anything to eat or drink after midnight prior to surgery. Pre-op medications should have been taken. Also, transportation and post-op care arrangements should have been made.
Most facial implant procedures are performed under deep sedation and local anesthesia. Surgery usually takes an hour or two, but the time required may vary considerably depending on the amount of work being done. During this time the patient is carefully monitored.
Chin implant surgery is best performed through a small incision in the crease under your chin. A pocket large enough for the implant is then created by gently lifting the skin and muscle off the chin bone. Sizers are then used to determine the most appropriate implant for your profile and expectations. Fine sutures close the incision and no dressing is required.
Cheek implant surgery is usually performed through incisions made in the mouth. Tunnels are raised to the cheek bone prominences and the implants positioned for maximum effect. Sometimes external stay sutures are used to prevent shifting in the early post-op phase. The intra-oral incisions are closed with dissolving sutures and no dressing is needed.
Nasal implant surgery is most often performed through an intra-oral incision above the upper lip. Sometimes an external small incision in the columella (partition between the nostrils) is used. After inserting the appropriate implant and closing the incision, a small nasal splint is applied to protect the implant for one week after surgery. No nasal packing is required.
After any facial implant surgery, the patient is then monitored in the recovery area for a few hours prior to discharge. It is mandatory for a patient who has had deep sedation to have someone stay with them the first night after surgery. The medications may affect judgment and co-ordination for 24 hours.
A: Follow-up visits vary according to the patient and the procedure. Most patients are seen again within one week.
Early post-op instructions usually include taking prescribed medications and appropriate oral and facial hygiene. If you have had an incision in your mouth, you should stick to fluids and soft food for the first week or so after surgery. You can brush your teeth the day after surgery and you should rinse your mouth several times a day with salt water, dilute peroxide or mouth wash. The stitches dissolve in 7-10 days. External skin stitches are removed 5-7 days after surgery.
Do not expect to look or feel great right after surgery. At first, you are going to look much worse than before. The implanted areas will be swollen and bruised and you may feel some pain from the tissue stretching. The discomfort can be controlled with pain medications. Most patients are quite active a few days after surgery and many are back to work or school within a week.
The healing process is gradual. While most of the swelling and discoloration will be gone a month or two after surgery, some swelling can remain for six months or more. Further follow-up is usually scheduled for six weeks and then six months after surgery. If you have any unusual symptoms between visits or any questions about what you can or can not do, do not hesitate to call us.
Strenuous activities are best avoided for at least 4-6 weeks post-op. Activities that might result in your face getting jarred or bumped in the first six weeks could result in implant displacement. The scar tissue which holds your implant in place takes at least this long to form.
A: Facial implant surgery is a highly effective technique for giving you a new contour with very little scarring. The results are permanent. Implant procedures can dramatically or subtly change the way you look and depending upon what you want most patients are very satisfied with the results of their surgery. See the Surgical Art Gallery for examples of this procedure.
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