Alloplastic cheek augmentation.

Alloplastic cheek augmentation can achieve an attractive malar prominence that is in balance and harmony with the other facial features. To reach this goal, the surgeon must first identify the proper candidate and then determine the type of malar deficiency. A vertical line through the lateral canthus allows the malar deficiency to be classified as anterior-medial, posterior-lateral, or combined. The proper implant is selected on the basis of the type of the defect and the degree of the deficiency. Different techniques are described that help the surgeon locate the site of the ideal malar eminence. Once that site is located, the surgeon outlines the proposed pocket for the implant. Both silicone and Proplast implants are successful. The insertion may be through the intraoral route, blepharoplasty approach, or under the face lift flap. The possible complications are discussed, but the complication rate is minimal.