Background: There are a wide variety of cheek looks that patients want from cheek augmentation surgery, most commonly achieved used implants. While typically done in patients that have flat or weak cheek bone prominences, contemporary cheek augmentation patients often seek improvements in their midfacial shapes that do not have any really inherent structural deficiencies.
One of the desires for some cheek enhancement patients is the ‘high cheekbone look’. While this is an aesthetic term that is well known, it has variable interpretations amongst patients and surgeons. What some patients say they want a high cheekbone look, that is often not exactly what they mean.
Technically such a look really refers to having the upper part of the cheekbone augmented throughout its length. Given the natural anatomy of the cheekbone (zygomatico-orbital-maxillary complex) this refers to a linear augmentation from the zygomatic arch across the upper half of the main body of the cheekbone which continues across the infraorbital rim. Such an augmentation must be more modest in most cases to not look unnatural.
Case Study: This young male wanted to enhance his infraorbital rim out across his cheeks, cresting the high cheekbone look. In the spirit of enhancing his natural bony anatomy a custom implant design was done that stayed within the shape of the bone adding a few millimeters of augmentation across the infraorbital rim and cheek.
Under general anesthesia subciliary lower eyelid skin incisions were made with a skin-muscle flap raised down to the bone. A long subperiosteal pocket was made from the nasal bones out past the mid-zygomatic arch suture back to the temporal bone. The implants were inserted and positioned up onto the infraorbital rims and secured with two microscrews per side. The eyelid incisions were closed with lateral canthopexies and orbicularius muscle resuspension sutures.
The high cheekbone look may be open to individual patient interpretation but its actual meaning is a linear augmentation along the cheekbone ‘line’ from the side of the nose to the back of the zygomatic arch.
Highlights:
1) The high cheek look really means a linear infraorbital-malar augmentation.
2) A custom implant can be made that creates a subtle but linear augmentation from the side of the nose back along the zygomatic arch.
3) A custom infraorbital-malar implant is placed through a lower eyelid incision for optimal positioning and fixation.
Dr. Barry Eppley
Indianapolis, Indiana