The goal: To increase the Zy-zy distance in long faces.
Females often have more forward projection in their cheekbones as well as fuller cheeks overall.
Sometimes cheek implants are used to feminise cheeks.
They come in different sizes and can be placed in different positions depending on the
needs of the patient.
We keep 3 things in mind:
- never exaggerate
- never too much volume
- never in the wrong places
The latter meaning: not too low, and not too median - it has to be a lateral
flow, to underline the Ogee curves.
To make this more female, we have the different procedures:
- A bone substitute material (Bio-Oss or hydroxyapatite) can be inserted.
- Implants can be used. The material I prefer above silicone is Medpor.
- Another possibility is fat transfer. Where fat is removed from another part of the body and injected into the cheeks to make them fuller.
- A sub-periosteal facelift is possible in case of saggy tissue.
- There is also a possibility to widen the arch and body of the zygoma (cheekbone) with an osteotomy, and putting a wedge (piece of bone) in between the gap.
The advantages of Bio-Oss: it is placed in a sub-periosteal pocket, through an intra-oral approach. This is our preference, because moulding is easy and the smooth edges at the border of the implant regions (zygomatic area, lateral orbital rim, lateral infra orbital rim area).
The maximum point of augmentation must be more lateral than infra-orbital in the direction of the arch, in order to avoid the 'miss-piggy' look.
Technique 1: with bone cement
Zygomaugmentation with artificial bone in a subperiosteal pocket via a intraoral approach.
Technique 2: with implants
Proper positioning (latero- cranial) of an sygoma implant.
Technique 3: with fat transfer