Panama Medical Vacations

Cosmetic & Plastic Surgery

Cheek Augmentation
Everyone remembers being a child and having Grandma pinch their cheeks. For some people that is more difficult than others since they don’t have the facial structure that creates prominent cheeks. Cheek augmentation is a surgery that increases the projection of the cheek or malar area which will enhance a deficient bony prominence or support sagging soft tissues. This can be achieved by implantation of synthetic silastic implants of different sizes and shapes, bone on-lay grafts or a bone cut (osteotomy) and advancement.

Prior to Surgery
Any necessary precautions prior to surgery will be outlined for you in the treatment plan. If you require pre-op therapy, you will receive the proper instructions. If you are a smoker, you may be asked to stop for a time prior to your surgery. You might also be asked to refrain from using vitamin E (in large does), aspirin or anti-inflammatory medicines since they can lead to increased bleeding during surgery.

The Procedure
The incision will be made in the predetermined placement, the implant situated directly on top of the cheek bone (or if need be, right below it) and checked for the proper look suitable for the patient's features. It is possible that it may be removed and further customized several times during the operation. The implant either sutured or screwed into place. Sometimes percutaneous sutures are used. This is where they stick partially out of the skin and can be removed later on by tugging gently on them after they have partially dissolved within. They can also be sutured with dissolvable stitches inside the surrounding tissues. Even still, the implants may not be sutured in at all, only the pocket, relying on your body's collagen to secure into place. If no implant/sutures are used you will more than likely have tape or a head wrapping that is worn at night to help it heal properly in the face.

After Your Surgery
After surgery, you will be sent to the recovery room. You will be groggy and maybe even a little confused at first, but the nurses will monitor your condition and provide assurance as you awake. Once you are full alert, you will be allowed to leave.

Your surgeon will instruct you to keep your head elevated for several days, and to use cold compresses to reduce swelling and bruising, which could last upwards of a month. You'll need to keep your external stitches dry and clean and if you have any stitches in your mouth you will need to gargle several times a day to clean them as well.

Risks
The risks associated with a cheek augmentation include:

  • Bleeding usually comes through the surface of resected bone. However, the use of surgical drains and ice pack immediately applied to the affected area will significantly reduce this risk. Infection is an uncommon risk. Prophylactic antibiotics is routinely administered pre and postoperatively.
  • A careful preoperative assessment and a complete set of bone reshaping instruments can prevent such problems.
  • The facial nerve may be temporarily disturbed. However, full recovery can be expected.
  • The permanent damage is very rare when performed by an experienced plastic surgeon.
  • For the mandibular angle resection, there is less chance of injury when using the intra-oral approach than the extra-oral one.

While there is always an element of risk, having an American-trained surgeon, a professional staff and a world-class hospital make your Panama brow lift at Hospital Punta Pacifica, Affiliated with Johns Hopkins Medicine International, a safe and rewarding procedure.