During the last 25 years, surgeons who perform cosmetic surgery have been more likely to appreciate and understand that when they take something away in facial rejuvenation, they should put something back, according to Joe Niamtu, III, D.M.D., an oral and maxillofacial surgeon with a practice limited to cosmetic facial surgery in Richmond, Va.
“This something can be fat, fillers a midface lifting procedure or implants,” he says.
Dr. Niamtu says he isn’t a fan of fat for the midface because it’s not reversible, and he believes fat placed in the cheek area will droop over time, becoming saggy.
“The fat you put in today may be in a different place in 20 years,” he says.
And midface lifting procedures will eventually fall, according to Dr. Niamtu. That’s where implants or fillers come in.
“It really has only been in the last 15 years where we’ve had predictable fillers that are thick enough to volumize the midface and had sufficient longevity,” he says.
The problem with fillers is they dissolve, and coming back repeatedly for filler treatments can get expensive for patients.
“If you do fillers two or three times, you’ve already paid for facial implants,” he says.
His go-to procedure for mid-face rejuvenation involves using cheek implants. The approach, he says, is relatively easy for the surgeon and patient, safe when implants are secured, permanent and reversible.
Cheek implants have been around for decades, and have improved thanks to the likes of William J. Binder, M.D., and Edward Owen Terino, M.D., who developed a series of implants customized to fit just about any human skeletal facial architecture, according to Dr. Niamtu.
“These implants come in an array of sizes and shapes to allow surgeons to customize how much and where the volume restoration is placed,” he says.